Effect of Carvedilol on Serum Heart-type Fatty Acid-binding Protein, Brain Natriuretic Peptide, and Cardiac Function in Patients With Chronic Heart Failure.

Abstract

OBJECTIVE:

To observe the changes of serum heart-type fatty acid-binding protein (h-FABP) and brain natriuretic peptide (BNP) in children with chronic heart failure (CHF) and evaluate the effects of carvedilol.

METHODS:

A total of 36 patients with CHF, including 17 of endocardial fibroelastosis and 19 of dilated cardiomyopathy, were enrolled and were randomly divided into a carvedilol treatment group (group A) and a conventional treatment group (group B). Group A (n = 16) was treated with carvedilol and conventional treatment and group B (n = 20) was managed with conventional treatment only. Thirty healthy children were enrolled as controls. The concentrations of serum h-FABP and BNP were measured by enzyme-linked immunosorbent assay, and the left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), and cardiac index (CI) were measured by echocardiography.

RESULTS:

The concentrations of serum h-FABP and BNP in patients with CHF were significantly higher than in the control group (21.7 ± 4.3 ng/mL vs. 6.3 ± 1.7 ng/mL, 582.4 ± 180.6 pg/mL vs.31.2 ± 9.8 pg/mL, all P < 0.01), positively correlated with the degree of heart failure (all P < 0.01), and were both higher in groups endocardial fibroelastosis and dilated cardiomyopathy than in the control group (all P < 0.01), but there was no statistically significant difference between the 2 groups (P > 0.05). h-FABP concentration in patients with CHF was positively correlated with BNP (r = 0.78, P < 0.01) but negatively correlated with LVEF, LVFS, and CI (r = -0.65, -0.64, and -0.71, respectively; all P < 0.01). BNP concentration was also negatively correlated with LVEF, LVFS, and CI (r = -0.75, -0.61, and -0.79, respectively; all P<0.01). After treatment with carvedilol, the serum concentrations of h-FABP and BNP in group A were lower than in group B, and the magnitude of heart rate reduction, improvement of LVEF, LVFS, and CI, and reduction of left ventricular end-systolic diameter and left ventricular end-diastolic diameter in group A were all greater than in group B (all P < 0.01). Treatment with carvedilol had no adverse events.

CONCLUSIONS:

Serum concentrations of h-FABP and BNP can be used as biomarkers to evaluate the severity of heart failure, and carvedilol can significantly improve heart function in children with CHF.

• Authors: Yu-Ping Sun, Chao-Ping Wei, Shao-Chun Ma, Yuan-Feng Zhang, Ling-Yan Qiao, De-Hua Li, Ruo-Bing Shan
• Journal: Journal of cardiovascular pharmacology (J Cardiovasc Pharmacol) Vol. 65 Issue 5 Pg. 480-4 (May 2015) ISSN: 1533-4023 [Electronic] United States
• PMID: 25945865 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Adrenergic beta-Antagonists
• Biomarkers
• Carbazoles
• FABP3 protein, human
• Fatty Acid Binding Protein 3
• Fatty Acid-Binding Proteins
• Propanolamines
• Carvedilol
• Natriuretic Peptide, Brain

Topics

• Adrenergic beta-Antagonists (adverse effects, therapeutic use)
• Age Factors
• Biomarkers (blood)
• Carbazoles (adverse effects, therapeutic use)
• Carvedilol
• Child
• Child, Preschool
• China
• Chronic Disease
• Echocardiography
• Enzyme-Linked Immunosorbent Assay
• Fatty Acid Binding Protein 3
• Fatty Acid-Binding Proteins (blood)
• Female
• Heart Failure (blood, diagnosis, drug therapy, physiopathology)
• Humans
• Infant
• Male
• Myocardial Contraction (drug effects)
• Natriuretic Peptide, Brain (blood)
• Predictive Value of Tests
• Propanolamines (adverse effects, therapeutic use)
• Severity of Illness Index
• Stroke Volume (drug effects)
• Treatment Outcome
• Ventricular Function, Left (drug effects)