Abstract

STUDY OF HEART TYPE FATTY ACID BINDING PROTEIN AS A MARKER OF MYOCARDIAL INJURY IN INFANTS AND YOUNG CHILDREN WITH CONGENITAL ACYANOTIC HEART DISEASES

Saneya Fahmy, Manal Abd El-Salam*, Nadia Youssef Riad and Fatma Abd El-Fattah Elsawy

Abstract

Background: The progression of heart failure is associated with a progressive loss of cardiomyocytes that can be detected clinically as continuously increased serum levels of H-FABP. However the clinical value of serum H-FABP levels in children and adolescents with congenital heart disease (CHD), has not yet been elucidated. Aim: To assess H-FABP serum level in infants and young children with congenital acyanotic heart disease as a marker of cardiac myocyte injury and correlate it with the severity of heart failure. Subjects and Methods: This case control study was conducted on 72 infants and young children with congenital acyanotic heart disease (left to right\ shunt). They were selected from outpatients’ pediatric clinics, pediatric department and pediatric ICU of National Heart Institute during the period from May 2013 to July 2015. The study also included 30 healthy infants and children, age and sex matched with patients, as controls. Assessment of H-FABP was performed in the same line with routine investigations for both groups. Radiological investigations included plain chest x-ray and conventional transthoracic echocardiogram. Results: Significant increase in H-FABP serum levels in patients (1.61 + 1.27 ng / mL) compared to the controls (0.43 + 0.18 ng / mL) with p (0.000) and significant relation to the severity of heart failure. Positive correlation between H-FABP and pulmonary pressure was detected. However, H-FABP showed a negative correlation with ejection fraction (EF) % and fraction shortening (FS) %. Conclusion: Levels of H-FABP can serve as a new monitoring tool to provide information about clinical heart failure severity and optimize therapy in management of patients with congenital heart defects.

Keywords: Congenital acyanotic heart disease, H-FABP, Heart failure.