Detection And Clinical Implication Of Levels Of Serum H-FABP And NT-proBNP In Patients Of Congenital Heart Disease With Pulmonary Artery Hypertension

Objective:The purpose of this study is to detect the levels of serum H-FABP and NT-proBNP in patients of congenital heart disease with pulmonary artery hypertension and investigate the clinical implication of them in congenital heart disease with pulmonary artery hypertension.Methods:63patients with CHD were collected. The patients with CHD were divided into21cases of non-pulmonary artery pressure (Group B),20cases of mild-to-moderate pulmonary artery pressure (Group C) and22cases of severe pulmonary artery pressure (Group D). In addition, we collected20cases of normal people as control group (Group A). The levels of serum H-FABP and NT-proBNP were detected by enzyme-linked immunosorbent assay (ELISA).Results:1. There were no significant differences of clinical characteristics between each group, such as age, gender composition, height, weight, alanine aminotransferase, creatinine, low density lipoprotein cholesterol, triglyceride(P>0.05).2. The median (interquartile range) of the levels of serum H-FABP measured by enzyme-linked immunosorbent assay are4.64(4.32-4.92) ng/ml,4.66(4.42-4.94) ng/ml,4.71(4.39-4.97) ng/ml,6.23(5.94-6.57) ng/ml respectively in Group A, Group B,Group C and Goup D. Compared to Group A, Group B and Group C, the level of serum H-FABP in Group D was obvious higher, and the differences were statistically significant (all P<0.05). In Group A, Group B and Group C, the levels of serum H-FABP showed no significantly differences between two of them (all P>0.05).3.The median (interquartile range) of the levels of serum NT-proBNP measured by enzyme-linked immunosorbent assay are8.65(7.38-9.58) ng/ml,9.36(8.36-10.83) ng/ml,9.75(8.61-10.83) ng/ml,13.14(9.17-25.07)ng/ml respectively in Group A, Group B,Group C and Group D. Compared to Group A, Group B and Group C, the level of serum NT-proBNP in Group D was obvious higher, and the differences were statistically significant (all P<0.05). In Group A, Group B and Group C, the levels of serum NT-proBNP showed no significantly differences between two of them (all P>0.05).4. Multivariate factors rank correlation analysis showed that there were positive correlations between level of serum H-FABP and level of serum NT-proBNP, level of serum blood uric acid, mean PAP, total pulmonary resistance(r=0.294,0.438,0.714,0.719respectively, all P <0.05). There were positive correlations between level of serum NT-proBNP and mean PAP, total pulmonary resistance(r=0.632、0.302respectively, all P<0.05). There were positive correlations between level of serum blood uric acid and mean PAP, total pulmonary resistance(r=0.373,0.279respectively, all P<0.05).5. CHD patients were divided into two groups according to New York Heart Association (NYHA) cardiac functional class. New York Heart Association (NYHA) class I was defined as Group A, New York Heart Association (NYHA) class11,111were defined as Group B, The levels of serum H-FABP were4.66(4.32-4.92) ng/ml,4.68(4.2-4.97) ng/ml,6.2(5.94-6.59) ng/ml respectively in control group, Group A and Group B. The levels of serum NT-proBNP were8.64(7.38-9.58) ng/ml,9.66(8.63-10.85) ng/ml,12.89(9.14-23.39) ng/ml respectively in control group, Group A and Group B. The levels of serum blood uric acid were266.07±13.82umol/L,270.79±56.08umol/L,319.34±51.07umol/L respectively in control group, Group A and Group B. Compared to control group and Group A, the levels of serum H-FABP, NT-proBNP and blood uric acid in group B were obvious higher, and the differences were statistically significant (all P<0.05). The levels of serum H-FABP, NT-proBNP and blood uric acid showed no significantly differences between control group and Group A (all P>0.05). Conclusions:1. The levels of serum H-FABP and NT-proBNP increased with increase of the pulmonary artery pressure in CHD patients.2. There were positive correlations between level of serum H-FABP and mean PAP, total pulmonary resistance, and also level of serum NT-proBNP, level of serum blood uric acid.3. As the worsen of the function of right heart, the level of serum H-FABP, NT-proBNP and blood uric acid increased, which indicated that H-FABP、NT-proBNP、blood uric acid has certain clinical implication in the diagnosis, monitor and therapy of right heart failure.