High peripheral levels of h-FABP are associated with poor prognosis in end-stage heart failure patients with mechanical circulatory support

Aim: To associate the time-course of h-FABP and N-terminal pro B-type natriuretic peptide (NT-proBNP) after left ventricular assist device (LVAD) implantation to outcome in end-stage heart failure patients. Materials & methods: Patients (n = 14, NYHA class III/IV; left ventricular ejection fraction <25% were enrolled; ten survived up to 1 month after LVAD (survivors) and four died of multiorgan failure within 2 weeks (nonsurvivors). Blood samples were obtained at admission; at 4, 24 and 72 h; and at 1 and 4 weeks after LVAD. Results: h-FABP significantly increases after surgery, decreasing since 72 h in all patients. At 72 h all survivor patients present h-FABP lower than the median value. N-terminal pro B-type natriuretic peptide is not associated with patient outcome at any time. Conclusion: High h-FABP levels, indicating the presence of more severe myocardial damage, are associated with a poor prognosis in patients with LVAD, suggesting that an early cardiac injury marker could improve the prediction of clinical outcome.