Rofo 2012; 184 - TNE17
DOI: 10.1055/s-0031-1300918

Heart type fatty acid binding protein (hFABP) in patients with acute congestive heart failure – a preliminary study

M Behnes 1, F Espeter 1, S Lang 1, P Ahmad-Nejad 2, M Neumaier 2, M Brueckmann 1, M Borggrefe 1, U Hoffmann 1
  • 1Universitätsmedizin Mannheim, I. Medizinische Klinik, Mannheim
  • 2Universitätsmedizin Mannheim, Institut für Klinische Chemie, Mannheim

Purpose:

Heart type fatty acid binding protein (hFABP) is a small cytoplasmatic protein being involved in cellular energy homeostasis. During ongoing myocardial damage hFABP is supposed to transport fatty acids from the cell membrane to mitochondria for oxidation. HFABP has been discussed as an early diagnostic marker in patients suffering from acute coronary syndromes. However, the role of hFABP in the diagnosis and prognosis of patients suffering from acute congestive heart failure (aCHF) has rarely been investigated. This study investigates serum levels of hFABP in patients suffering from acute congestive heart failure (aCHF).

Patients and Methods:

80 patients presenting to the emergency department with symptoms of acute dyspnea and/or peripheral edema were evaluated for this analysis. Patients with dyspnea or edema caused by an acute myocardial infarction or myocarditis were excluded for this preliminary analysis. Serum blood samples for measurement of hFABP (hFABP ELISA, Signosis, Inc) were collected immediately after the initial clinical presentation of the aCHF patients in the emergency department.

Results:

Mean hFABP levels were significantly higher in patients with a history of aCHF (13.71ng/ml, n=40) compared to patients without (11.1ng/ml, n=40) (P=0.02). HFABP levels were significantly higher in patients being classified to functional NYHA class III/IV (14.1ng/ml, n=35) compared to those of NYHA class I/II (10.4 pg/ml, n=9) (P=0.09). Accordingly, hFABP levels were significantly higher in patients being classified to structural ACC/AHA class C/D (13.2ng/ml, n=48) compared to those of class A/B (11.4ng/ml, n=21) (P=0.03). HFABP levels were correlated with the clinically estimated likelihood for the diagnosis of aCHF in the emergency department (probability of 0–25%, mean 10.4ng/ml; 75–100%, mean 14.3ng/ml; P=0.01). Mortality rate of all patients was 11% (9/80) after 1 year and 30% (24/80) after 5 years. Serum levels of hFABP were not able to differentiate surviving patients from those who deceased during clinical follow-up periods of 1 and 5 years in this smaller cohort.

Conclusion:

It was demonstrated that hFABP serum levels were increased in patients suffering from aCHF. hFABP was associated with functional NYHA, structural AHA/ACC classification and the clinically estimated likelihood for the diagnosis of aCHF. Increased levels of hFABP might indicate patients with acute congestive heart failure at higher functional or structural disease stages. The role of hFABP to predict long term mortality in aCHF patients needs to be investigated in larger clinical trials.