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- Title
Association of free fatty acid binding protein with central aortic stiffness, myocardial dysfunction and preserved ejection fraction heart failure.
- Authors
Yen, Chih-Hsuan; Lin, Jiun-Lu; Sung, Kuo-Tzu; Su, Cheng-Huang; Huang, Wen-Hung; Chen, Yun-Yu; Chien, Shih-Chieh; Lai, Yau-Huei; Lee, Ping-Ying; Liu, Yen-Yu; Tsai, Jui-Peng; Tsai, Cheng-Ting; Hou, Charles Jia-Yin; Chen, Ying-Ju; Hsieh, Yu-Jou; Hung, Chung-Lieh; Hung, Ta-Chuan; Yeh, Hung-I.
- Abstract
There is an established link between cardiometabolic abnormality, central arterial stiffness, and preserved ejection fraction heart failure (HFpEF). Adipocyte free fatty acid binding protein (a-FABP) has been shown to signal endothelial dysfunction through fatty acid toxicity, though its role in mediating ventricular-arterial dysfunction remains unclear. We prospectively examined the associations of a-FABP with central arterial pressure using non-invasive applanation tonometry (SphygmoCor) and cardiac structure/function (i.e., tissue Doppler imaging [TDI] and global longitudinal myocardial strain [GLS]) in patients with cardiometabolic (CM) risk (n = 150) and HFpEF (n = 50), with healthy volunteers (n = 49) serving as a control. We observed a graded increase of a-FABP across the healthy controls, CM individuals, and HFpEF groups (all paired p < 0.05). Higher a-FABP was independently associated with higher central systolic and diastolic blood pressures (CSP/CPP), increased arterial augmentation index (Aix), lower early myocardial relaxation velocity (TDI-e′), higher left ventricle (LV) filling (E/TDI-e′) and worsened GLS (all p < 0.05). During a median of 3.85 years (interquartile range: 3.68–4.62 years) follow-up, higher a-FABP (cutoff: 24 ng/mL, adjusted hazard ratio: 1.01, 95% confidence interval: 1.001–1.02, p = 0.04) but not brain natriuretic peptide, and higher central hemodynamic indices were related to the incidence of heart failure (HF) in fully adjusted Cox models. Furthermore, a-FABP improved the HF risk classification over central hemodynamic information. We found a mechanistic pathophysiological link between a-FABP, central arterial stiffness, and myocardial dysfunction. In a population with a high metabolic risk, higher a-FABP accompanied by worsened ventricular-arterial coupling may confer more unfavorable outcomes in HFpEF.
- Subjects
FATTY acids; CARRIER proteins; HEART failure; ENDOTHELIUM diseases; HEMODYNAMICS
- Publication
Scientific Reports, 2021, Vol 11, Issue 1, p1
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/s41598-021-95534-1