ORIGINAL ARTICLES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2001 December;42(6):735-40

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Influence of renal function on serum and urinary heart fatty acid-binding protein levels

Nayashida N., Chihara S., Tayama E., Akasu K., Kai E., Kawara T., Aoyagi S.

From the Department of Surgery Kurume University, Fukuoka, Japan

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Back­ground. ­Serum ­heart ­fatty ­acid-­binding pro­tein (H-­FABP) has ­been ­reported to be a sen­si­tive and ­early indi­cator of myo­car­dial ­damage. How­ever, cir­cu­lating H-­FABP may be ­cleared con­sid­er­ably ­from ­kidney, sim­ilar to ­that ­found for myo­globin. There­fore, the pos­sibility ­exists ­that any ­change in ­renal func­tion ­affects ­serum H-­FABP con­cen­tra­tion, and ­thus ­leads to erro­neous inter­pre­ta­tion. To eval­uate the influ­ence of ­renal func­tion on H-­FABP ­levels, we con­ducted a pros­pec­tive ­study.
­Methods. Nine­teen ­patients under­going iso­lated pri­mary cor­o­nary ­artery ­bypass ­grafting ­were ­enrolled in ­this ­study. The ­patients ­were clas­si­fied by the pre­op­er­a­tive crea­ti­nine clear­ance ­into two ­groups: the con­trol ­group (n=12); ­patients ­with crea­ti­nine clear­ance of 40 mL/min or ­greater, and the ­renal dys­func­tion ­group (n=7); ­patients ­with crea­ti­nine clear­ance of ­less ­than 40 mL/min. ­Serum H-­FABP, CK-MB, tro­ponin-T and uri­nary H-­FABP ­levels ­were meas­ured per­i­op­er­a­tively.
­Results. ­None of the ­patients had per­i­op­er­a­tive myo­car­dial infarc­tion. No sig­nif­i­cant dif­fer­ences ­were ­found in CK-MB and tro­ponin-T ­levels ­between the ­groups. The ­renal dys­func­tion ­group ­resulted in sig­nif­i­cantly (p<0.05) ­higher ­serum H-­FABP ­levels and ­lower uri­nary H-­FABP ­levels ­than ­those in the con­trol ­group, post­op­er­a­tively. The crea­ti­nine clear­ance cor­re­lated ­inversely ­with the ­peak ­levels of ­serum H-­FABP (r=-0.75, p=0.0001) and cor­re­lated ­with the ­peak ­levels of uri­nary H-­FABP (r=0.64, p=0.003).
Con­clu­sions. The ­results indi­cate ­that the kid­neys ­play an impor­tant ­role in the clear­ance of ­serum H-­FABP. ­Thus, cau­tion ­must be ­taken in inter­preting ­this ­marker for myo­car­dial ­damage ­during car­diac sur­gery in ­patients ­with ­renal dys­func­tion.