title: Circulating intestinal fatty acid-binding protein (I-FABP) levels in acute decompensated heart failure.
abstract: BACKGROUND
  Venous congestion has become increasingly recognized as a potential contributor to end-organ dysfunction in heart failure. Elevated I-FABP, which is excreted specifically from damaged intestinal epithelial cells, has been found in patients with abdominal hypertension and intestinal ischemia. We hypothesize that elevated intestinal fatty acid-binding protein (I-FABP) levels would identify patients with more advanced heart failure who have venous and intestinal congestion.
  
  
  METHODS
  Baseline serum I-FABP levels were measured in 69 acute decompensated heart failure (ADHF) patients admitted to the intensive care unit for invasive hemodynamic monitoring and tailored medical therapy. Comprehensive echocardiography examinations were performed in all study patients, and clinical outcomes (death, cardiac transplant or left ventricular assist device placement) were assessed.
  
  
  RESULTS
  The median circulating I-FABP level was 853pg/ml (interquartile range: 533 to 1448pg/ml). Age, gender, race, and baseline comorbidities were comparable between patients with low and high I-FABP levels. Although there were no significant correlations between I-FABP levels and invasively-measured hemodynamic parameters nor echocardiographic parameters, patients with higher I-FABP levels (≥853g/ml) had significantly worse clinical outcomes compared to those with lower I-FABP levels (<853pg/ml, P=0.025).
  
  
  CONCLUSIONS
  Circulating I-FABP levels had no association with invasively-measured hemodynamic parameters, but were associated with adverse clinical outcomes in patients with ADHF with systolic dysfunction.
authors.affiliation: Kaufman Center for Heart Failure, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kitai
authors.affiliation: Kaufman Center for Heart Failure, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: Yong-Hyun
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland, OH, United States.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Kiefer
authors.affiliation: Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland, OH, United States.
authors.forename: Rommel
authors.initials: R
authors.lastname: Morales
authors.affiliation: Kaufman Center for Heart Failure, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: Allen G
authors.initials: AG
authors.lastname: Borowski
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States.
authors.forename: Justin L
authors.initials: JL
authors.lastname: Grodin
authors.affiliation: Kaufman Center for Heart Failure, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States; Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland, OH, United States. Electronic address: tangw@ccf.org.
authors.forename: W H Wilson
authors.initials: WHW
authors.lastname: Tang
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D003422:Critical Care; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: C493404:FABP2 protein, human; D050556:Fatty Acid-Binding Proteins
keywords: Acute heart failure; Biomarker; Cardiorenal; I-FABP