Heart-Type Fatty Acid-Binding Protein (H-FABP) in Patients with Coronary Artery Bypass Graft Surgery Undergoing Cardiac Rehabilitation Program

Heart-type Fatty Acid-Binding Protein (H-FABP), compared with classical biomarkers, proved to have high sensitivity for myocardial damage size in patients undergoing cardiac surgery. High H-FABP levels are strongly associated in case of death, post-operatively acute kidney injury and atrial fibrillation. Cardiac rehabilitation is an instrument of medical management in cardiovascular diseases; beyond prevention, it can improve heart and muscle functioning in patients that were undergoing CABG, and cardiac and vascular adaptation. Over a 2-year period, 110 subjects were randomized and comprehensively evaluated. The mean age of the patients under study was 65.70 � 9.91 years old. For the H-FABP, the mean value in the Phase I was 67.40 � 9.81 ng/mL, while the mean value in Phase III was 4.80 � 2.30 ng/mL. The difference registered between the plasma H-FABP value in the first 24 h after cardiac surgery and the value in 6 months after the onset of cardiac rehabilitation program was important and statistically significant, as p [ 0.05. Fibrinogen showed significant phase-to-phase reductions of plasmatic values. Lipid profile values showed a statistically significant decrease. The renal filtration function evaluated by plasma creatinine showed statistically significant improvement and, in terms of absolute values, creatinine level was reduced in a range between 0.2-0.4 mg/dL. Also, it was recorded a significantly lower level of blood urea. The reduction of plasma H-FABP values were registered between the first phase (the first 24 h) after cardiac surgery and the third phase of the cardiac rehabilitation program. H-FABP protein had a higher sensitivity and specificity when compared to other enzymes of myocardial cytolysis.

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Heart-Type Fatty Acid-Binding Protein (H-FABP) in Patients with Type 2 Diabetes Beneficiaries of Rehabilitation Program Post Coronary Artery Bypass Grafting

Revista de Chimie ◽

10.37358/rc.18.10.6608 ◽

2018 ◽

Vol 69 (10) ◽

pp. 2712-2717

Author(s):

Razan Al Namat ◽

Maura Gabriela Felea ◽

Irina Iuliana Costache ◽

Viviana Aursulesei ◽

Antoniu Petris ◽

...

Keyword(s):

Type 2 Diabetes ◽

Fatty Acid ◽

Coronary Artery ◽

Cardiac Rehabilitation ◽

Fatty Acid Binding Protein ◽

Artery Bypass ◽

Rehabilitation Program ◽

Fatty Acid Binding ◽

Acid Binding Protein

Heart-type fatty acid-binding protein (H-FABP) is a non-invasive bio-marker, with high sensitivity and specificity, being capable to point out the myocardial injury and to predict major adverse cardiovascular events (MACE). Cardiac rehabilitation program, through a complex and sustained post-interventional management plays an important role in reducing the plasma levels of H-FABP. In the study, which included 120 post-coronary artery bypass (CABG) patients, we analyzed the link between low levels of general post-surgical health status and the presence of cardiovascular risk factors, common biochemical markers, and especially the role played by diabetic status in lowering the plasma H-FABP levels. From the group, 65 patients had been diagnosed with type 2 Diabetes Mellitus (T2DM). The H-FABP values decreased both in diabetics and in non-diabetics between the two phases of CR, 6 months away from CABG. More than half of the patients had important reduction of H-FABP, at 6 months after the onset of CR program. Half of the group registered a smaller reduction of H-FABP, but more noticeable in diabetics. Ischemic lesion during open heart surgery is linked to high levels of H-FABP and with an occurence risk of postoperative atrial fibrillation, that can be also triggered and sustained by multiple endocrine conditions related to aging. Thus, metabolic control should always remain a target of the complex management in cardiac rehabilitation.

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DIABETIC PATIENTS HAVE INCREASED PERIOPERATIVE CARDIAC RISK COMPARED WITH OTHER CLINICAL RISK FACTORS IN NON-CARDIAC SURGERY IN HEART-TYPE FATTY ACID-BINDING PROTEIN BASED ASSESSMENT

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(13)61393-5 ◽

2013 ◽

Vol 61 (10) ◽

pp. E1393

Author(s):

Harun Kilic ◽

Munevver Sari ◽

Ramazan Akdemir

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Fatty Acid ◽

Fatty Acid Binding Protein ◽

Binding Protein ◽

Cardiac Risk ◽

Clinical Risk Factors ◽

Diabetic Patients ◽

Fatty Acid Binding ◽

Acid Binding Protein

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Prevention of gastrointestinal injury by using glutamine in cardiac surgery

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2014-3-19-23 ◽

2015 ◽

Vol 18 (3) ◽

pp. 19 ◽

Cited By ~ 1

Author(s):

S. M. Yefremov ◽

V. A. Shmyrev ◽

M. N. Deryagin ◽

I. A. Kornilov ◽

A. N. Shilova ◽

...

Keyword(s):

Cardiac Surgery ◽

Fatty Acid ◽

Fatty Acid Binding Protein ◽

Binding Protein ◽

Intestinal Damage ◽

Double Blind ◽

Fatty Acid Binding ◽

Double Blind Placebo ◽

Intestinal Integrity ◽

Acid Binding Protein

A pilot double-blind, placebo-controlled, randomized study The aim of this study was to evaluate the efficiency of perioperative administration of glutamine to preserve intestinal integrity in patients undergoing cardiac surgery. 24 patients scheduled for elective coronary artery bypass surgery under cardiopulmonary bypass were included in this prospective, randomized, double-blind placebo controlled pilot study. 12 patients were randomized to receive glutamine (20% solution of N(2)-L-alanyl-L-glutamine) 0.4 g/kg a day, while the remaining 12 patients received an equivalent placebo dose (0.9% solution of NaCl). Infusion of glutamine/placebo was started after the induction of anesthesia and was continued for 24 hours. The primary end-point was dynamics of plasma concentration of a specific marker of intestinal damage, intestinal fatty acid binding protein (I-FABP). The secondary end-points were liver fatty acid binding protein (L-FABP), alpha glutathione s-transferase (aGST), heat shock protein 70 (HSP 70). There were no between-group differences of all the studied biochemical parameters at any stage of the study. Plasma I-FABP levels (median [25-75 percentile]) were markedly elevated during CPB and remained the same postoperatively: 962 (577-2 067) and 883 (444-1 625) г/ml 5 min after un-clamping of aorta, 2203 (888-3 429) and 1 560 (506-2 657) г/ml <sup>2</sup> hours post-bypass, 897 (555-1 424) and 794 (505-951) г/ml 6 hours post-bypass in the GLN and control groups respectively. Perioperative administration of glutamine in dose of 0.4 g/kg a day does not appear to preserve intestinal integrity in low risk cardiac surgery patients.

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