title: Serum heart-type fatty acid-binding protein concentration positively correlates with the length of aortic dissection.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Osaka Mishima Emergency and Critical Care Center, Osaka, Japan. hazui112@osaka-mishima.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hazui
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Negoro
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nishimoto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Muraoka
authors.forename: Motonobu
authors.initials: M
authors.lastname: Murai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takeshita
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohishi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fukumoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morita
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: 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
chemical_list: D015415:Biomarkers; D002352:Carrier Proteins; D050556:Fatty Acid-Binding Proteins