Prognostic Value Of Heart Type Fatty Acid Binding Protein In Acute Pulmonary Embolism With Hemodynamic Stability

Objective:To explore the prognostic value of heart type fatty acid binding protein and heart type fatty acid binding protein unite plasma hypersensitivity of troponin T, plasma brain natriuretic peptide, the short axis of right ventricular/left ventricular diameter (RVd/LVd) ratio in acute pulmonary embolism with hemodynamic stability.Methods:A total of 130 APE patients with hemodynamic stability were enrolled[79 men and 51 women;age(68.90±13.47)years]. According to the 2014 ESC guidelines for the management of APE diagnosis, divided into low risk, Intermediate-low risk, Intermediate-high risk groups, among the groups H-FABP, cTNT-hs, BNP, RVd/LVd and complicated clinical course occurrence whether there are differences;All had 30-day follow-up and divided them into the complicated clinical course group(n=16) and the non complicated clinical course group(n=114), Compare the differences of H-FABP, cTNT-hs, BNP and RVd/LVd between the two groups, and compare the value and advantage of each index and the combined index to predict the complex clinical course in early stage.Results:1.130 cases of APE patients with hemodynamic stability divided into low risk, Intermediate-low risk, Intermediate-high risk groups, three groups of H-FABP respectively 4.04 (0.43) ng/ml,5.67 (0.88) ng/ml,6.73 (0.45) ng/ml, cTNT-hs for 0.008 (0.004) ng/ml,0.017 (0.006) ng/ml,0.038 (0.035) ng/ml, the BNP for 85.45 (12.61) pg/ml,104.00 (30.10) pg/ml,136.10 (28.20) pg/ml, RVd/LVd ratio 0.41 (0.04),0.58 (0.07),0.63 (0.05). there were significant difference(P<0.05) among the three groups.2.130 cases of APE patients with hemodynamic stability, complex clinical course group H-FABP 6.88 (0.32) ng/ml, cTNT-hs 0.022(0.049)ng/ml, BNP 141.10 (13.93) pg/ml, RVd/LVd ratio 0.67 (0.06) and less complex clinical process group H-FABP 5.57(2.13) ng/ml, cTNT-hs 0.016 (0.013) ng/ml, BNP 99.10 (32.93) pg/ml, RVd/LVd ratio 0.58 (0.19), there were significant difference(P<0.05) among the two groups. And H-FABP AUC 0.934 [95%CI:(0.888-0.980)], cTNT-hs AUC 0.743[95%CI:(0.630-0.856)], BNP AUC 0.895[95%CI:(0.814-0.976)], RVd/LVd ratio AUC 0.876[95%CI:(0.786-0.967)].3.Using ROC curve to calculate the best prognosis value of H-FABP, cTNT-hs, BNP and RVd/LVd ratio, Comparison the sensitivity, specificity, positive predictive value, negative predictive value of H-FABP, cTNT-hs, BNP and RVd/LVd ratio, H-FABP has superiority. and H-FABP joint cTNT-hs, BNP and RVd/LVd ratio early prognostic effect in patients with acute pulmonary embolism is higher than cTNT-hs, BNP and RVd/LVd ratio combined prediction effect.Conclusion:H-FABP have predictive value to the hemodynamic stability of patients with acute pulmonary embolism, and H-FABP combined with cTNT-hs, BNP, RVd/LVd index for prognostic value of complex clinical process better.