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ORIGINAL ARTICLE
Year : 2018  |  Volume : 5  |  Issue : 1  |  Page : 42-51

Heart-type fatty-acid-binding protein is a prognostic biomarker for sepsis outcome and sepsis-related left-ventricular dysfunction: a comparison with troponin I


Critical Care Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Hossam M Sherif
Critical Care Center, Cairo University Hospitals, El Manial, Cairo, 11562
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_8_17

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Background Using heart-type fatty-acid-binding protein (H-FABP) in critically ill patients provides a superior results than the conventional cardiac biomarkers. Objective The aim of the study was to estimate the prognostic significance of H-FABP in patients with septic shock and the prevalence of sepsis-related myocardial dysfunction in comparison to troponin I. Patients and methods Fifty ICU patients with sepsis were enrolled in this study. All patients were evaluated using Acute Physiology and Chronic Health Evaluation II score on admission and every 24 h during ICU stay. Serum levels of both H-FABP and troponin I were investigated during the first 24 h after admission. Using modified Simpson’s method, echocardiographic left-ventricular end-diastolic volume (LVEDV), left-ventricular end-systolic volume (LVESV), and left-ventricular ejection fraction (LV%EF) were calculated on admission and after 24 h. Results The patients were divided into two groups: group 1, which included 12 patients (mean age: 50.2±21 years) suffering from sepsis; and group 2, which included 38 patients (mean age: 58.4±19.2 years) with septic shock. Compared with group 1, H-FABP of group 2 showed significant higher values (76.3 vs. 33.3% of patients, P<0.05). In both groups, compared with patients with negative H-FABP, patients with positive H-FABP showed significantly increased values (66 vs. 34%, P<0.05). The positive H-FABP patients showed significantly increased left ventricular volumes (LVEDV=105 vs. 77 ml, P<0.05; and LVESV=49 vs. 33 ml, P<0.05). The mortality rate was significantly higher in group 2 compared with group 1 (78.9 vs. 41.7%, P<0.05). H-FABP was a better prognostic marker than troponin I; it showed an increased prevalence of mortality (88 vs. 35%, P<0.001) with good correlation (r=0.54, P<0.05). Conclusion In septic shock, H-FABP can be used as a prognostic marker for mortality rathar than troponin I. The positive H-FABP patients showed a significant relation with sepsis-related left-ventricular systolic myocardial dysfunction.


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