Research On The Early Diagnostic Value Of Heart Type Fatty Acid Binding Protein For Myocardial Injury During Perioperation Of Cardiac Surgery

Purpose: During the perioperation of cardiac mitral valve replacement(MVR) under cardiopulmonary bypass(CPB), the dynamic change of heart type fatty acid binding protein(H-FABP) in cardiac patients were monitored to discuss the diagnostic value in the early perioperative myocardial injury by comparing the level of cardiac troponin I(c Tn I) and creatine kinase-myocardial band isoenzyme(CK-MB).Methods: 60 patients were selected to accept cardiac surgery for MVR under CPB from April to October, 2014 in the hospital with no sex, age and weight restrictions. Exclusion criteria included main organic disease such as brain, lung, liver and kidney disease. The venous blood samples were selected to test the concentrations of H-FABP, c Tn I, CK-MB by ELISA at the time point of preanesthesia, postanesthesia, aortic clamping, and 15 min, 1 h, 3 h, 6 h, 9 h, 12 h, 24 h after aortic declamping, respectively. The change trend among H-FABP, c Tn I and CK-MB were compared to investigate the early diagnostic value of H-FABP in perioperative myocardial injury.Results: 1. The level of H-FABP, c Tn I, CK-MB were in the normal range before the time of anesthesia induction. There was no significant difference in the level of preanesthesia, postanesthesia and aortic clamping. The level of H-FABP, c Tn I, CK-MB in preanesthesia was significantly higher than the level of the time point after aortic clamping 15 min, separately. H-FABP reached the peak level after aortic clamping 1 h(P﹤0.05), returned to normal level within 24 h(P﹥0.05). c Tn I, CK-MB reached the peak level after aortic clamping 12 h(P﹤0.05), did not return to normal level within 24 h(P﹤0.05).2. After aortic clamping 15 min, H-FABP level was 19.94 times higher than the level of the time point for preanesthesia, the increased range of H-FABP level was exceed the same time point of c Tn I(4.69 times) and CK-MB(1.75 times). After aortic clamping 1h, H-FABP peak level was 36.48 times higher than the level of the time point for preanesthesia, the increased range of H-FABP level was exceed the peak level of c Tn I(11.00 times) and CK-MB(4.74 times).3. The peak level of H-FABP was positively correlated with c Tn I and CK-MB. The correlation coefficient r for the peak level of the H-FABP and c Tn I was 0.727(P﹤0.05),The correlation coefficient rfor the peak level of the H-FABP and CK-MB was 0.791(P﹤0.05).Conclusion:H-FABP is able to predict perioperative myocardial injury early and effectively. Compared with c Tn I and CK-MB, H-FABP is a superior marker in early monitoring and diagnosing in perioperative myocardial injury, which can be used as one of the biochemical marker for its early diagnosis in perioperative myocardial injury.