Author + information
- Takeshi Kitai,
- Yong-Hyun Kim,
- Kathryn Kiefer,
- Rommel Morales,
- Justin Grodin and
- W.H. Wilson Tang
Background: Decreased intestinal barrier function and an altered gut microbiota composition have been reported in HF patients. Elevated levels of intestinal fatty acid-binding protein (I-FABP), which is excreted specifically from damaged intestinal epithelial cells, have been observed in patients with abdominal hypertension and intestinal ischemia. We hypothesized that elevated I-FABP levels would identify patients with more advanced HF who have venous and intestinal congestion.
Methods: Baseline I-FABP levels were measured in 69 patients with advanced decompensated HF (ADHF) who underwent with invasive hemodynamic monitoring and comprehensive echocardiography examinations. Adverse events including death, cardiac transplant or left ventricular assist device [LVAD] placement were assessed.
Results: In our study cohort (age: 58±13 years, left ventricular ejection fraction: 28±9 %, right atrial pressure: 12.6±5.9 mmHg, pulmonary capillary wedge pressure: 21.2±7.2 mmHg, cardiac index: 2.1±0.7 L/min//m2), the median circulating I-FABP level was 853 pg/ml (interquatile range: 533 to 1448 pg/ml). Although there were no significant correlations between I-FABP levels and hemodynamic parameters, a modest positive correlation was found between I-FABP and trymethylamine N-oxide (TMAO) levels, a gut microbial metabolite (ρ=0.33 P=0.007). During a median follow-up of 1062 days, there were 21 (30.4%) deaths, 20 (29.0%) heart transplantations and 8 (11.6%) LVAD placements. Patients with higher I-FABP levels (≥853 g/ml) had significantly worse clinical outcomes compared to those with lower I-FABP levels (<853 pg/ml, P=0.036).
Conclusions: I-FABP levels had no association with hemodynamic parameters, but were positively associated with TMAO levels and adverse clinical outcomes in patients with ADHF. Our results may suggest that dysbiosis can contribute to higher levels of I-FABP in advanced HF patients.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1294-285
- 2017 American College of Cardiology Foundation