title: Ongoing myocardial damage in patients with heart failure and preserved ejection fraction.
abstract: BACKGROUND
  The relationship between ongoing myocardial damage and heart failure with preserved left ventricular systolic function (HF-PEF) is still unclear. To investigate this relationship, we measured the cardiac-specific cytosolic marker, heart-type fatty acid binding protein (H-FABP), and a myofibrillar component (troponin T), and analyzed clinical outcomes.
  
  
  RESULTS
  Consecutive heart failure patients (n=151) with echocardiographic left ventricular ejection fraction >50% were prospectively enrolled. The cut-off values for myocardial membrane injury (H-FABP >4.3 ng/mL) and myofibrillar injury (troponin T >0.01 ng/mL) were defined using receiver operating characteristic curves. Myocardial membrane injury was observed more frequently than myofibrillar injury (41% vs. 26% of patients, p<0.05). Patients were followed up for a median of 694 days, with the end-points being cardiovascular death or re-hospitalization. By multivariate analysis, the serum H-FABP level was an independent predictor of cardiovascular events (hazard ratio 1.165 per 1 ng/mL increase, 95% confidence interval 1.034-1.314, p=0.012).
  
  
  CONCLUSIONS
  Latent myocardial injury was frequently observed in patients with HF-PEF. The circulating H-FABP level was an independent predictor of subsequent cardiovascular events.
authors: The Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Daisuke
authors: D
authors: Kutsuzawa
authors: Takanori
authors: T
authors: Arimoto
authors: Tetsu
authors: T
authors: Watanabe
authors: Tetsuro
authors: T
authors: Shishido
authors: Takuya
authors: T
authors: Miyamoto
authors: Takehiko
authors: T
authors: Miyashita
authors: Hiroki
authors: H
authors: Takahashi
authors: Takeshi
authors: T
authors: Niizeki
authors: Yasuchika
authors: Y
authors: Takeishi
authors: Isao
authors: I
authors: Kubota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000473:pathology; D011446:Prospective Studies; D012306:Risk; D013318:Stroke Volume; D013599:Systole; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D020107:Troponin T