Combined assessment of myocardial damage and electrical disturbance in chronic heart failure.

Abstract

AIM:

To investigate feasibility of combined assessment of biochemical and electrophysiological myocardial impairment markers risk-stratifying patients with chronic heart failure (CHF).

METHODS:

Serum levels of heart-type fatty acid binding protein (H-FABP) as a marker of ongoing myocardial damage and QRS duration on electrocardiogram were measured at admission in 322 consecutive patients with CHF. A prolonged QRS duration was defined as 120 ms or longer. The cut-off value for H-FABP level (4.5 ng/mL) was determined from a previous study. Patients were prospectively followed during a median follow up period of 534 d. The primary endpoint was cardiac deaths and rehospitalization for worsening CHF.

RESULTS:

There were 117 primary events, including 27 cardiac deaths and 90 rehospitalizations. Patients were stratified into four groups according to H-FABP level and QRS duration (≥ 120 ms). Multivariate analysis demonstrated that high H-FABP levels [hazard ratio (HR) = 1.745, P = 0.021] and QRS prolongation (HR 1.612, P = 0.0258) were independent predictors of cardiac events. Kaplan-Meier analysis demonstrated that the combination of high H-FABP levels and QRS prolongation could be used to reliably stratify patients at high risk for cardiac events (log rank test P < 0.0001).

CONCLUSION:

Combined assessment of myocardial damage and electrical disturbance can be used to risk-stratify patients with CHF.

• Authors: Shinpei Kadowaki, Tetsu Watanabe, Yoichiro Otaki, Taro Narumi, Yuki Honda, Hiroki Takahashi, Takanori Arimoto, Tetsuro Shishido, Takuya Miyamoto, Isao Kubota
• Journal: World journal of cardiology (World J Cardiol) Vol. 9 Issue 5 Pg. 457-465 (May 26 2017) ISSN: 1949-8462 [Print] United States
• PMID: 28603594 (Publication Type: Journal Article)