Serum heart-type fatty acid-binding protein concentration positively correlates with the length of aortic dissection.
BACKGROUND
Patients with aortic dissection (AD) often demonstrate positive heart-type fatty acid-binding protein (H-FABP), but its significance is unclear.


RESULTS
In 63 of 64 consecutive AD patients, the serum H-FABP concentration was measured and the H-FABP positive rate calculated (cutoff value: 6.2 ng/ml) for each of following factors: (1) with or without dissection of the ascending aorta; and (2) a thrombosed false lumen; (3) length score; (4) presence of shock; (5) malperfusion of limbs; (6) ST elevation and/or depression on electrocardiogram; and (7) renal dysfunction. In total 36 AD patients had a positive H-FABP test. Statistically significant differences in the H-FABP positive rate were observed between those with and without ascending AD (76.7% vs 39.4%, p = 0.003), and in the length score (p < 0.001). Multivariate logistic regression test demonstrated that the most significant factor was the length score (odds ratio: 2.239 (95% confidence interval: 1.119-4.481), p = 0.023). Moreover, a significant correlation was observed between length score and absolute H-FABP value (r = 0.420, p = 0.001).


CONCLUSIONS
In patients with AD, an increased serum H-FABP concentration is caused by the protein being released not only from the cardiac muscle but also from skeletal muscle, or possibly the aortic wall. Physicians using H-FABP for detection of myocardial injury need to be aware that patients with a long or ascending AD will show an elevation of H-FABP.
Hazui
Hiroshi
H
Department of Emergency Medicine, Osaka Mishima Emergency and Critical Care Center, Osaka, Japan. hazui112@osaka-mishima.jp
Negoro
Nobuyuki
N
Nishimoto
Masayoshi
M
Muraoka
Hideyuki
H
Murai
Motonobu
M
Takeshita
Hitoshi
H
Ohishi
Yasuo
Y
Fukumoto
Hitoshi
H
Morita
Hiroshi
H
Hanafusa
Toshiaki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology; D001019:Aortic Rupture / Q000097:blood* / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D002352:Carrier Proteins / Q000097:blood*; D050556:Fatty Acid-Binding Proteins; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D011237:Predictive Value of Tests
D015415:Biomarkers; D002352:Carrier Proteins; D050556:Fatty Acid-Binding Proteins