Effect of Carvedilol on Serum Heart-type Fatty Acid-binding Protein, Brain Natriuretic Peptide, and Cardiac Function in Patients With Chronic Heart Failure

被引:22
|
作者
Sun, Yu-ping [1 ]
Wei, Chao-ping [1 ]
Ma, Shao-chun [1 ]
Zhang, Yuan-feng [1 ]
Qiao, Ling-yan [1 ]
Li, De-hua [1 ]
Shan, Ruo-bing [1 ]
机构
[1] Women & Childrens Hosp Qingdao City, Qingdao 266000, Peoples R China
关键词
heart failure; chronic; fatty acid-binding protein; heart-type; brain natriuretic peptide; carvedilol; children; ACUTE MYOCARDIAL-INFARCTION; DILATED CARDIOMYOPATHY; PEDIATRIC-PATIENTS; DIAGNOSIS; CHILDREN; SEVERITY; INFANTS; DISEASE; AGE;
D O I
10.1097/FJC.0000000000000217
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To observe the changes of serum heart-type fatty acid binding protein (h-FABP) and brain natriuretic peptide (BNP) in children with chronic heart failure (CHF) and evaluate the effects of carvedilol. Methods: A total of 36 patients with CHF, including 17 of endocardial fibroelastosis and 19 of dilated cardiomyopathy, were enrolled and were randomly divided into a catvedilol treatment group (group A) and a conventional treatment group (group B). Group A (n = 16) was treated with carvedilol and conventional treatment and group B (n = 20) was managed with conventional treatment only. Thirty healthy children were enrolled as controls. The concentrations of serum h-FABP and BNP were measured by enzyme-linked immunosorbent assay, and the left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), and cardiac index (Cl) were measured by echocardiography. Results: The concentrations of serum h-FABP and BNP in patients with CHF were significantly higher than in the control group (21.7 +/- 4.3 ng/mL vs. 6.3 +/- 1.7 ng/mL, 582.4 +/- 180.6 pg/mL vs.31.2 +/- 9.8 pg/mL, all P < 0.01), positively correlated with the degree of heart failure (all P < 0.01), and were both higher in groups endocardial fibroelastosis and dilated cardiomyopathy than in the control group (all P < 0.01), but there was no statistically significant difference between the 2 groups (P > 0.05). h-FABP concentration in patients with CHF was positively correlated with BNP (r = 0.78, P < 0.01) but negatively correlated with LVEF, LVFS, and CI (r = -0.65, -0.64, and -0.71, respectively; all P < 0.01). BNP concentration was also negatively correlated with LVEF, LVFS, and CI (r = -0.75, -0.61, and -0.79, respectively; all P<0.01). After treatment with carvedilol, the serum concentrations of h-FABP and BNP in group A were lower than in group B, and the magnitude of heart rate reduction, improvement of LVEF, LVFS, and CI, and reduction of left ventricular endsystolic diameter and left ventricular end-diastolic diameter in group A were all greater than in group B (all P < 0.01). Treatment with carvedilol had no adverse events. Conclusions: Serum concentrations of h-FABP and BNP can be used as biomarkers to evaluate the severity of heart failure, and carvedilol can significantly improve heart function in children with CHF.
引用
收藏
页码:480 / 484
页数:5
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