Circulating heart-type fatty acid-binding protein levels predict ventricular fibrillation in Brugada syndrome

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• 作者：Hyuma Daidoji ; MD ; Takanori Arimoto ; MD ; ^{t-arimoto@med.id.yamagata-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Tadateru Iwayama ; MD ; Daisuke Ishigaki ; MD ; Naoaki Hashimoto ; MD ; Yu Kumagai ; MD ; Satoshi Nishiyama ; MD ; Hiroki Takahashi ; MD ; Tetsuro Shishido ; MD ; Takuya Miyamoto ; MD ; Tetsu Watanabe ; MD ; FJCC ; Isao Kubota ; MD ; FJCC
• 关键词：Brugada syndrome ; Heart-type fatty acid-binding protein ; Implantable cardioverter-defibrillator
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：67
• 期：3
• 页码：221-228
• 全文大小：454 K

文摘

The association between ongoing myocardial damage and outcomes in patients with Brugada syndrome who had received an implantable cardioverter-defibrillator (ICD) is unclear.

Methods

Consecutive patients with Brugada syndrome (n = 31, 50 ± 13 years) who had received an ICD were prospectively enrolled. Minor myocardial membrane injury [heart-type fatty acid-binding protein (H-FABP) >2.4 ng/mL] and myofibrillar injury (troponin T >0.005 ng/mL) were defined using receiver operating characteristic curves. Patients were followed for a median period of 5 years to an endpoint of appropriate ICD shock.

Results

Myocardial membrane injury (29%) and myofibrillar injury (26%) were similarly prevalent among patients with Brugada syndrome who had received ICDs. Appropriate ICD shocks occurred in 19% of patients during the follow-up period. Multivariate Cox regression analysis showed that serum H-FABP level >2.4 ng/mL, but not troponin T level, was an independent prognostic factor for appropriate ICD shock due to ventricular fibrillation [hazard ratio (HR) 25.2, 95% confidence interval (CI) 1.33–1686, p = 0.03].

Conclusions

Evaluating myocardial damage using H-FABP may be a promising tool for predicting ventricular arrhythmia in patients with Brugada syndrome who have received ICDs.