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More than 140 million people worldwide live >2500m above sea level. Changes in human physiology, pathology, pathogenesis, and clinical features of the heart and pulmonary circulation are reported during high altitude exposure. Remodeling of the heart following injury affects the morbidity and mortality in patients presented with congestive heart failure (CHF). Heart-type fatty acid binding protein (H-FABP) is released into the circulation when the myocardium is injured and is a novel marker for the diagnosis of acute myocardial infarction.yet, Few study have explored the effect of different altitude hypoxia (2260m, 3300m) on H-FABP in elderly patients(≥65 years old) with congestive heart failure. The aim of the present study was to explore the significance of the levels change of serum H-FABP in elderly patients with CHF at the different altitude, and effects of the levels change at the different altitude on left ventricular mass index(LVMI), mean wall stress(MWS).
62 CHF patients from high altitude(3300m) were studied and 67 CHF from moderate altitude (2260m) were enrolled as controls, the serum levels of H-FABP were detected by ELISE. Their Left ventricular ejection fraction (LVEF), LVMI and MWS were measured by echocardiography.
Compared with moderate altitude group, the serum levels H-FABP were obviously increased in high altitude group [(38.85±6.43) ng/ml vs (27.36±5.76) ng/ml, p<0.01]. Similarly,LVMI and MWS were significantly higher in high altitude group[ (189.7±9.5) vs (96.3±8.4) g/m2 and (476.2±14.9) vs (304.7±13.5) dynes x103/cm 2, respectively, all p<0.01]. there was a positive correlation between LVMI, MWS and the levels of H-FABP (all P<0.01).
Hypoxia increased the changes of ventricular remodeling via the induction of H-FABP. With the increase of altitude, CHF patients had higher levels of H-FABP, it suggest the changes of H-FABP pay certain roles in pathophysiological and pathogenetic mechanism of ventricular remodeling in CHF from high altitude.