The Diagnostic Value Of Serum Heart-Type Fatty Acid Binding Protein And Hypersensitive C-Reactive Protein In Ischemic Cardiomyopathy

Objective:It is sometimes difficult to distinguish ischemic cardiomyopathy from dilated cardiomyopathy in patients with enlarged heart and reduced left ventricular systolic function.In recent years,the gradual maturity of coronary angiography has provided a relatively accurate basis for the identification of the two diseases.However,coronary angiography is invasive and relatively expensive,which is often unacceptable to patients.Therefore,this study investigated the differential value of serum heart-type fatty acid-binding protein and serum hypersensitive c-reactive protein in dilated cardiomyopathy and ischemic cardiomyopathy and its relationship with the severity of heart failure.Method:From March 2018 to February 2019 in the second affiliated hospital of Anhui Medical University in elderly patients with heart 60 cases in hospital with heart failure,including30 patients with dilated cardiomyopathy(male 18,female 12 patients,aged 45-64),30 patients with ischemic cardiomyopathy(male 20 cases,10 cases of women,aged55-70),and healthy control group 15 cases(male 8 cases,female 7 cases,aged 44-56).Exclusion criteria: all the patients were performed coronary artery angiography revealed clear coronary conditions(DCM patients did not see significant coronary artery stenosis and coronary angiography in patients with ischemic cardiomyopathy display one or multivessel coronary artery stenosis > 70%),improve the heart colour to exceed prompt cardiomegaly,ejection fraction of 50% or less,to rule out heart valve disease,hypertensive heart disease,cor pulmonale,congenital heart disease,hypertrophic cardiomyopathy,alcoholic cardiomyopathy,acute or chronic infectious disease, systemic autoimmune disease,malignant tumor,thyroid disease,cerebrovascular disease,patients with severe hepatic and renal insufficiency.Patients with dilated cardiomyopathy and ischemic cardiomyopathy were divided into three subgroups according to the NYHA classification standard of cardiac function,and serum H-FABP and hs-CRP levels in each group were determined by ELISA.SPSS22.0 statistical software was used for data analysis.Results1.The mean serum H-FABP level of patients in the dilated cardiomyopathy group and the ischemic cardiomyopathy group was higher than that in the control group(5.05±1.21)ug/L,(5.11±1.13)ug/L and(1.13±0.69)ug/L,respectively.The mean serum H-FABP level of patients in the dilated cardiomyopathy group was similar to that in the ischemic cardiomyopathy group.Patients with DCM group and ischemic cardiomyopathy average serum hs-CRP levels are higher than the control group,respectively(3.95-1.29 mg/L),(5.68-1.97 mg/L),(1.03-0.33 mg/L),and ischemic cardiomyopathy patients serum hs-CRP levels higher than that of patients with DCM group,the difference was statistically significant(P < 0.05),suggesting the hs-CRP serum levels in DCM and has important significance in the differential diagnosis of ischemic cardiomyopathy.2.There was no significant difference in serum H-FABP level between dilated cardiomyopathy group and ischemic cardiomyopathy group at the same NYHA(P >,0.05).Serum H-FABP and hs-CRP levels in patients with dilated cardiomyopathy and ischemic cardiomyopathy increased with the severity of heart failure,and serum H-FABP and hs-CRP levels in patients with NYHA III and IV were significantly higher than those in patients with NYHA II(P < 0.05).3.The hs-CRP level of patients in dilated cardiomyopathy group and ischemic cardiomyopathy group was used as the cut-off point of diagnosis,and then the true positive rate(sensitivity)and false positive rate(1-specificity)at different cut-off points were used as the ordinate and the abscissa to connect the points and draw the ROC curve.According to the ROC curve,the sensitivity and specificity of hs-CRP level5.24mg/L were 66.7% and 86.7% respectively for the diagnosis of ischemic cardiomyopathy.Conclusion1.Hs-CRP is an important index to distinguish dilated cardiomyopathy group from ischemic cardiomyopathy group.2.H-FABP can be used to evaluate the severity of heart failure in patients.Serum h-fabp level increases with the aggravation of cardiac failure.