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Objective To investigate the value of the serum heart fatty acid binding protein (H-FABP) in the assessment of cardiac function in patients with rheumatic heart disease (RHD).Methods Forty-five RHD patients hospitalized in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to December 2016 were selected as the observation group.In addition,45 subjects with normal cardiac function in the same period were selected as control group.The levels of serum H-FABP,B-type natriuretic peptide(BNP),left ventricular end-diastolic dimension(LVEDD),left ventricular end-systolic dimension(LVESD) and left ventricular ejection fraction(LVEF) were compared in the groups.The correlation between serum H-FABP and BNP,cardiac function classification was analyzed.Results The serum H-FABP and BNP levels and LVEDD,LVESD in the observation group were significantly higher than those in the control group(P ＜ 0.05),but the LVEF in the observation group was significantly lower than that in the control group(P ＜ 0.05).There were significant differences in the serum H-FABP,BNP levels and LVEDD,LVESD,LVEF among the patients with class Ⅱ,Ⅲ and Ⅳ of heart function (P ＜0.05).The serum H-FABP,BNP levels and LVEDD,LVESD in the patients with class Ⅲ and Ⅳ of heart function were significantly higher than those in the patients with class Ⅱ of heart function(P ＜ 0.05);but the LVEF in the patients with class Ⅲand Ⅳ of heart function was significantly lower than that in the patients with class Ⅱ of heart function(P ＜0.05).Compared with the patients with class Ⅲ of heart function,the serum H-FABP,BNP levels and LVEDD,LVESD in the patients with class Ⅳ of heart function were significantly higher(P ＜ 0.05);but the LVEF in the patients with class Ⅳ of heart function was significantly lower(P ＜ 0.05).The serum H-FABP level was positively correlated with serum BNP level,LVEDD and LVESD in the observation group (r =0.579,0.743,0.740;P ＜ 0.05).but it was negatively correlated with LVEF (r =-0.801,P ＜0.05).Conclusion The serum H-FABP level increases with the aggravation of heart failure in patients with RHD.It can be used as an important index to evaluate the heart function and prognosis of RHD patients.
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Objective To investigate the clinical significance of heart fatty acid binding protein (H-FABP) and pregnancy associ-ated plasma protein A(PAPP-A) in acute coronary syndrome(ACS) .Methods A case-control study was conducted in 60 patients with ACS ,45 patients with stable angina pectoris (SAP) and50 patients without coronary heart diseases (control group) .All plasma samples were tested H-FABP and PAPP-A .Results Concentrations of H-FABP and PAPP-A were significantly different among the 3 groups(P<0 .01) .H-FABP and PAPP-A in ACS group were significant higher than those of SAP group and control group (P<0 .01) ,however there were no significant differences between SAP and control group (P>0 .05) .The sensitivity and specificity of H-FABP were 91 .7% and 78 .0% respectively analyzed by ROC curve .Similarly ,the sensitivity and specificity of PAPP-A were 48 .3% and 98 .0% respectively .The correlation of H-FABP and PAPP-A was high(r=0 .835 ,P<0 .01) according to the analysis by Pearson correlation analysis .Conclusion Concentrations of plasma H-FABP and PAPP-A had close relationship with ACS ,the sensitivity of H-FABP was much higher ,both of which could be the potential biomarkers and contributed to the diagnosis of exist-ence and progress of ACS .
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Objective To investigate the value of high sensitive cardiac troponin T(hs-cTnT),human heart fatty acid binding protein(H-FABP),B-type natriuretic peptide(BNP),ischemia modified albumin(IMA) and creatine kinase(CK-MB) in the diagnosis of myocardial injury in preeclampsia.Methods A total of 50 women of normal pregnancy in preganancy group,and 50 healthy women without pregnacy were collected in control group,167 women in preeclampsia group (42 cases with myocardial injury,125 cases without myocardial injury).The serum IMA were detected by albumin cobalt binding test,H-FABP were detected by ELISA,hs-cTnT and BNP were detected by microparticle chemiluminescence immunoassay and CK-MB were detected by immuno-suppression.Results Five cardiac markers levels in myocardial injury group of preeclampsia group were significantly higher than those in healthy control group and normal pregnancy women and non myocardial injury group[(t=8.521,7.489,7.256;7.561,6.897,6.235;12.314,9.236,10.251;13.657,11.023,12.031;11.301,10.364,15.567),(P=0.008,0.030,0.035;0.027,0.031,0.033;0.002,0.005,0.003;0.002,0.004,0.003;0.003,0.004,0.001)].There was no significant difference in hs-cTnT among control group and normal pregnancy women and non myocardial injury group[(t=1.678,1.401;1.887,1.784),(P=0.339,0.401;0.289,0.398)].IMA、H-FABP、CK-MB and BNP in normal pregnancy women and non myocardial injury group were higher than in control group [(t=4.784,4.021;3.894,3.784;5.801,5.215),(P=0.024,0.032;0.037,0.041;0.021,0.029)].There was no significant difference in IMA,H-FABP,CK-MB and BNP between normal pregnancy women and non myocardial injury group [(t=1.325,1.257,1.241);(P=0.451,0.329,0.378)].The sensitivity of combined detection of five cardiac markers in preeclampsia myocardial injury was significantly higher than that in single marker(χ2=3.021,3.561,4.215,4.496,5.249;P=0.027,0.024,0.019,0.015,0.009).Conclusion When myocardial damage in pregnant women was determined by cardiac markers,pregnancy should be taken into account as a special physiological cycle.The combined detection of five cardiac markers is conducive to early diagnosis of ischemic myocardial injury in preeclampsia.
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Objective To observe the relationship between serum level of H-FABP before percutaneous coronary intervention (PCI) and prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Methods A total of 104 cases were recruited in this study. PCI was performed 12 h after onset. The concentration of H-FABP was detected before operation. Gensini score system was used to calculate the integral of all patients after coronary angiography. According to Gensini score, patients were divided into three groups, 34 cases in group A (8≤Gensini scores<41), 34 cases in group B (41≤Gensini scores<64) and 36 cases in group C (Gensini scores≥64). Indicators were analyzed statistically including systolic blood pressure (SBP), diastolic blood pressure (DBP), smoking history, H-FABP, left ventricular ejection fraction (LVEF), total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), fasting blood sugar, diabetes (DM) and hypertension. The patients were followed up for 12 months after operation. According to the occurrence of major adverse cardiovascular events (MACE), patients were divided into MACE group and non-MACE group. The related factors of two groups were statistically analyzed. The multivariate Logistic regression analysis was used to screen the risk factors of MACE for patients with STEMI after emergency PCI. Results There is a gradually increasing tendency in total cholesterol levels among three A, B and C groups (P<0.05). LVEF values were lower in B group and C group than that of A group (P<0.05). There were no significant differences in levels of SBP, DBP, H-FABP, TG, HDL-C, LDL-C, fasting plasma glucose and smoking history, DM, and hypertension between three groups (P>0.05). In 12-month follow-up, the proportion of STEM combined with DM, the time from onset to PCI, the level of TC, the level of H-FABP before operation and Gensini score were significantly higher in MACE group than those of non-MACE group (P<0.05). Logistic regression analysis showed that STEM combined with DM, higher serum level of H-FABP before operation were risk factors of MACE in 12-month after operation (P<0.05). Conclusion For patients with acute STEM combined with diabetes and elevated preoperative serum level of H-FABP, be alert to the occurrence of MACE in 12-month after PCI.
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Acute myocardial ischemia is the most common cause of sudden cardiac death.The diagnosis of early myocardial ischemia is a hot point in forensic medicine,which is also an early and important part for a prevention against myocardial infarction.This paper conducts a comprehensive discussion of the structure,function,clinical value and forensic medicine application prospect of ischemia modified albumin (IMA) and heart-type fatty acid binding protein (H-FABP),aiming to determine whether the two proteins can be used as biochemical detection indicators of early myocardial ischemia for the diagnosis of sudden cardiac death in forensic medicine.
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Objective To investigate the clinical significance of heart fatty acid binding protein (H-FABP) and pregnancy associ-ated plasma protein A(PAPP-A) in acute coronary syndrome(ACS) .Methods A case-control study was conducted in 60 patients with ACS ,45 patients with stable angina pectoris (SAP) and50 patients without coronary heart diseases (control group) .All plasma samples were tested H-FABP and PAPP-A .Results Concentrations of H-FABP and PAPP-A were significantly different among the 3 groups(P<0 .01) .H-FABP and PAPP-A in ACS group were significant higher than those of SAP group and control group (P<0 .01) ,however there were no significant differences between SAP and control group (P>0 .05) .The sensitivity and specificity of H-FABP were 91 .7% and 78 .0% respectively analyzed by ROC curve .Similarly ,the sensitivity and specificity of PAPP-A were 48 .3% and 98 .0% respectively .The correlation of H-FABP and PAPP-A was high(r=0 .835 ,P<0 .01) according to the analysis by Pearson correlation analysis .Conclusion Concentrations of plasma H-FABP and PAPP-A had close relationship with ACS ,the sensitivity of H-FABP was much higher ,both of which could be the potential biomarkers and contributed to the diagnosis of exist-ence and progress of ACS .
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Objective To explore the effect of Shuxuening on early myocardial injury markers and oxidative stress in severe sepsis patients with myocardial injury. Methods A total of 102 severe sepsis patients with myocardial injury, who received therapy in our hospital from Mar. 2013 to Jun. 2016, were randomly divided into two groups; control group (51 cases) and therapy group (51 cases). The patients in the control group received routine treatments and the therapy group were given Shuxuening based on routine treatment. We detected the levels of plasma N-terminal pio-brain natriuretic peptide (NT-proBNP), heart-type fatty acid binding protein (hFABP), cardiac troponin I (cTnl), malondialdehyde (MDA), superoxicle dismutase (SOD) and gluiaihione peroxidase (GSH-Px) of patients before treatment (at admission), after treatment for 6 h and 72 h (after admission), and analyzed the change of left ventricular ejection fraction (LVEF), acute physiology, chronic health evaluation (APACHE) || score, length of ICU slay and 28-day mortality of the patients. Results At admission, there was no difference in the levels of plasma NT-proBNP, hFABP, cTnl. MDA. SOD. GSH-Px, APACHE || score or LVEF between the two groups (P>0.05). After treatment for 6 h, the levels of plasma NT-proBNP, hFABP, cTnl and MDA in the therapy group were significantly lower and the activities of plasma SOD and GSH-Px were significantly higher than those in the control group (P0. 05). APACHE II scores after treatment were significantly lower than that before treatment in the two groups (P0. 05). The therapy group had a significantly lower 28-day mortality than the control group (0. 05). The therapy group had a significantly lower mortality than the control group (P<0. 05). Conclusion Therapeutic effect of Shuxuening on the severe sepsis patients with myocardial injury is superior to the routine treatment. Shuxuening can decrease the levels of NT-proBNP. hFABP. cTnl, and MDA and APACHE || score, and can increase the activities of SOD and GSH-Px.
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Objective To evaluate the relationship between the change of Heart-fatty acid-binding protein and myocardial injury/infarction in postoperative of off-pump coronary artery bypass grafting (OPCAB).Methods 59 patients (male 37 and female 22,from 46 to 83 years old) who were the first time to undergoing OPCAB were included in this study.Serial venous blood samples were taken at after induction of anesthesia,the OPCAB finished (after the last anastomosis),entered ICU,2,4 and 8 hours after the patient entered ICU,and at 1 and 2 day postoperative to test H-FABP.The cTnI and CK-MB were tested at 4 and 8 hours,after entering ICU,and at 1 and 2 days postoperative.Patients were divided into 3 groups by the changes of ECG and the level of cTnl at 8 hours after they entered ICU:normal group (group I,cTnI ＜0.1 ng/ml),myocardial injury group(group Ⅱ,cTnI 0.l-1.0 ng/ml) and.myocardial infarction group(group Ⅲ,cTnI ＞ 1.0 ng/ml).Results The level of H-FABP released was significantly higher in the myocardial infarction group than normal group and myocardial injury group (P ＜ 0.01).There is good correlation between the H-FABP and cTnI or CK-MB.But the peak level of H-FABP is earlier (finished OPCAB) (P ＜ 0.05),and it peaked early at 2h after entered ICU (P ＜ 0.01),it began to decrease at 4 hours after entered ICU and returned to baseline at 1 day postoperative,while the cTnI and CK-MB peaked at postoperative day 1 and 8h after entered ICU respectively,and maintained in higher level at postoperative 2 days.Conclusion There is good correlation between the H-FABP and perioperative myocardial infarction in OPCAB,and it has superiority compared with cTnI,which is as gold standard for perioperative myocardial infarction,on a certain degree.It can benefit from early detection of H-FABP for myocardial infarction in perioperative of OPCAB.
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Objective:To investigate the stability of heart fatty-acid-binding protein(H-FABP)for the postmortem diagnosis of early myocardial infraction.Methods:Rabbit model of myocardial ischemia was induced by ligating the anterior branch of the left coronary artery.The areas of H-FABP depletion in the ischemic myocardial cells were studied by immunohistochemistry,image analysis technique and statistical system.Results:The specimens of normal myocardium kept at 4℃ for 1 to 2 days showed homogenous brown reactions for H-FABP.The depletion of H-FABP became evident when these specimens were kept at 4℃ for 3 days after death,and the depletion area increased with the lapse of postmortem interval.The depletion area of H-FABP in ischemic myocardial tissue also increased with the lapse of postmortem interval.The results of image analysis indicated that the depletion area of H-FABP in ischemic myocardial tissue within 4 d were significantly different from that in the normal control group(P0.05).Conclusion:The H-FABP shows medium postmortem stability,and small influenced by autolysis,which is suitable for detection in corpses at 4℃ 4 days after death.H-FABP as a marker for postmortem diagnosis of AMI has some practical value in forensic medicine.