血清FABP4预测持续性心房颤动和收缩性心力衰竭患者消融反应和预后的研究  

Serum FABP4 Level Predicts Response to Ablation and Outcomes in Patients with Persistent Atrial Fibrillation and Systolic Heart Failure

作　　者：李海丽 吴永宁 刘南朝 陈运起 LI Haili;WU Yongning;LIU Nanchao;CHEN Yunqi(Department of Geriatrics,Hainan West Central Hospital,Danzhou 571700,Hainan,China;Department of Cardiology,Hainan West Central Hospital,Danzhou 571700,Hainan,China)

机构地区：[1]海南西部中心医院老年病科,儋州市571700 [2]海南西部中心医院心血管内科,儋州市571700

出　　处：《中国分子心脏病学杂志》2023年第2期5299-5304,共6页Molecular Cardiology of China

基　　金：海南省卫生健康行业科研项目(21A200320)。

摘　　要：目的分析血清脂肪细胞型脂肪酸结合蛋白4(FABP4)与持续性心房颤动(PAF)和收缩性心力衰竭(HF)患者消融反应和预后的相关性。方法选取2019年10月至2021年12月接受消融治疗的81例有HF症状(纽约心脏协会分级Ⅱ-Ⅳ级)、左室射血分数(LVEF)≤40%的PAF患者。采用酶联免疫吸附测定法检测血清FABP4水平。术后12个月未发生心源性死亡、心脏移植以及因HF入院治疗定义为无事件生存。6个月时存活、窦性心律以及LVEF≥50%定义为消融有反应。结果反应组患者的血清FABP4水平显著低于无反应组[(17.76±5.13)ng/ml vs.(26.62±17.66)ng/ml,P=0.001]。采用受试者操作特征曲线分析,血清FABP4水平对PAF患者消融反应的预测效能曲线下面积为0.724,截断值为16.55 ng/ml。经Log Rankχ2检验血清FABP4低水平患者术后无事件生存率显著高于FABP4高水平患者(χ2=4.061,P=0.044)。单因素及多因素logistic回归分析结果显示,血清FABP4水平为PAF患者术后消融无反应及预后不良的独立预测因子(P<0.05)。结论术前血清FABP4高水平可识别接受PAF消融治疗的收缩性HF患者中消融无反应者、预测消融预后情况。Objective To analyze the correlation between serum fatty acid binding protein 4(FABP4)and ablation response and prognosis in patients with persistent atrial fibrillation(PAF)and systolic heart failure(HF).Methods 81 patients with PAF and HF symptoms(New York Heart Association gradeⅡ-Ⅳ)and left ventricular ejection fraction(LVEF)≤40%were enrolled in our hospital from October 2019 to December 2021.Serum FABP4 level were determined by enzyme-linked immunosorbent assay.Event-free survival was defined as absence of cardiac death,heart transplantation,and hospitalization for HF at 12 months.Survival,sinus rhythm,and LVEF≥50%at 6 months were defined as responding to ablation.Results The serum FABP4 level in response group was significantly lower than that in non-response group([17.76±5.13]ng/ml vs.[26.62±17.66]ng/ml,P=0.001).According to the receiver operating characteristic curve analysis,the area under the curve for predicting the ablation response of PAF patients with serum FABP4 level was 0.724 and the cut-off value was 16.55 ng/ml.After Log Rankχ2 test,the event-free survival rate of patients with low serum FABP4 level was significantly higher than that of patients with high serum FABP4 level(χ2=4.061,P=0.044).Univariate and multivariate logistic regression analysis showed that serum FABP4 level was an independent predictor of non-response to postoperative ablation and poor prognosis in patients with PAF(P﹤0.05).Conclusion Preoperative high serum FABP4 level can identify non-ablation patients with systolic HF who received PAF ablation and predict the prognosis of ablation.

关 键 词：脂肪细胞型脂肪酸结合蛋白 持续性心房颤动 收缩性心力衰竭 消融反应 预后 

分 类 号：R541.75[医药卫生—心血管疾病] R541.6[医药卫生—内科学]