Is heart-type fatty acid binding protein (H-FABP) a valid marker of arterial stiffness in patients with systemic sclerosis?

Arterial stiffness in systemic sclerosis



Systemic sclerosis, Heart fatty acid binding protein, Arterial stiffness, Pulse wave velocity, Homocysteine


Background/Aim: Both micro- and macro-vascular involvement has been researched in systemic sclerosis (SSc) for many years. In this study, the relationship of arterial stiffness with heart-type fatty acid binding protein (h-FABP), which is well-accepted as a cardiac marker, was investigated for the first time.

Methods: In this case-control study, 40 patients diagnosed with SSc between the ages of 18 and 65 were included. Thirty healthy individuals of similar age and gender were included as the control group. Patients were excluded from the study if they had cardiovascular risk factors, active infections, and/or malignancies. Along with detecting biochemical markers in the blood, results from methods, such as 24-h blood pressure Holter recordings, pulse-wave velocities (PWV), and echocardiograms (ECHO) were obtained from patients.

Results: The homocysteine mean level was higher in the patient group than in the control group (P < 0.001). H-FABP and asymmetric dimethylarginine (ADMA) means were similar between the two groups (P = 0.286 and P = 0.340, respectively). Vascular parameters, including mean arterial pressure (MAP), augmentation index normalized to the 75 /min heart rate (AIx @ 75), and PWV were also similar between the two groups (P = 0.498, P = 0.382 and P = 0.180, respectively).

Conclusion: It can be concluded that no ongoing myocardial damage occurs based on normotensive Holter findings, normal h-FABP levels, and ECHO findings in our patients. It is suggested that vasodilatory treatments, such as pentoxifylline and calcium channel blockers, which the patients receive for SSc treatment due to Raynaud Syndrome, may protect them from hypertension and therefore offer protection from myocardial damage.


Download data is not yet available.


Varga J. Systemic sclerosis: an update. Bull NYU Hosp Jt Dis. 2008;66(3):198-202.

Ho M, Veale D, Eastmond C, Nuki G, Belch J. Macrovascular disease and systemic sclerosis. Ann Rheum Dis. 2000 Jan;59(1):39-43. DOI:

Gosse P, Taillard J, Constans J; ERAMS Study Investigators. Evolution of ambulatory measurement of blood pressure and parameters of arterial stiffness over a 1-year period in patients with systemic sclerosis: ERAMS study. J Hum Hypertens. 2002 Sep;16(9):627-30. DOI:

Szucs G, Tímár O, Szekanecz Z, Dér H, Kerekes G, Szamosi S, et al. Endothelial dysfunction precedes atherosclerosis in systemic sclerosis--relevance for prevention of vascular complications. Rheumatology (Oxford). 2007 May;46(5):759-62. DOI:

Jung KH, Lim MJ, Kwon SR, Kim D, Joo K, Park W. Nailfold capillary microscopic changes and arterial stiffness in Korean systemic sclerosis patients. Mod Rheumatol. 2015 Mar;25(2):328-31. DOI:

Gedikli O, Ozturk S, Yilmaz H, Baykan M, Kiris A, Durmus I, et al. Relationship between arterial stiffness and myocardial damage in patients with newly diagnosed essential hypertension. Am J Hypertens. 2008 Sep;21(9):989-93. DOI:

Zhang HW, Jin JL, Cao YX, Liu HH, Zhang Y, Guo YL, et al. Heart-type fatty acid binding protein predicts cardiovascular events in patients with stable coronary artery disease: a prospective cohort study. Ann Transl Med. 2020 Nov;8(21):1349. DOI:

Otaki Y, Watanabe T, Takahashi H, Hirayama A, Narumi T, Kadowaki S, et al. Association of heart-type fatty acid-binding protein with cardiovascular risk factors and all-cause mortality in the general population: the Takahata study. PLoS One. 2014 May 21;9(5):e94834. DOI:

Pang X, Liu J, Zhao J, Mao J, Zhang X, Feng L, et al. Homocysteine induces the expression of C-reactive protein via NMDAr-ROS-MAPK-NF-κB signal pathway in rat vascular smooth muscle cells. Atherosclerosis. 2014 Sep;236(1):73-81. DOI:

Wierzbicki AS. Homocysteine and cardiovascular disease: a review of the evidence. Diab Vasc Dis Res. 2007 Jun;4(2):143-50. DOI:

Turiel M, Gianturco L, Ricci C, Sarzi-Puttini P, Tomasoni L, Colonna Vde G, et al. Silent cardiovascular involvement in patients with diffuse systemic sclerosis: a controlled cross-sectional study. Arthritis Care Res (Hoboken). 2013 Feb;65(2):274-80. DOI:

Domsic RT, Dezfulian C, Shoushtari A, Ivanco D, Kenny E, Kwoh CK, et al. Endothelial dysfunction is present only in the microvasculature and microcirculation of early diffuse systemic sclerosis patients. Clin Exp Rheumatol. 2014 Nov-Dec;32(6 Suppl 86):S-154-60. Epub 2014 Nov 5.

Čypienė A, Dadonienė J, Miltinienė D, Rinkūnienė E, Rugienė R, Stropuvienė S, et al. The fact not to ignore: Mean blood pressure is the main predictor of increased arterial stiffness in patients with systemic rheumatic diseases. Adv Med Sci. 2017 Sep;62(2):223-9. DOI:

Hettema ME, Zhang D, de Leeuw K, Stienstra Y, Smit AJ, Kallenberg CG, et al. Early atherosclerosis in systemic sclerosis and its relation to disease or traditional risk factors. Arthritis Res Ther. 2008;10(2):R49. DOI:

Stratos C, Stefanadis C, Kallikazaros I, Boudoulas H, Toutouzas P. Ascending aorta distensibility abnormalities in hypertensive patients and response to nifedipine administration. Am J Med. 1992 Nov;93(5):505-12. DOI:

Liu J, Zhang Y, Cao TS, Duan YY, Yuan LJ, Yang YL, et al. Preferential macrovasculopathy in systemic sclerosis detected by regional pulse wave velocity from wave intensity analysis: comparisons of local and regional arterial stiffness parameters in cases and controls. Arthritis Care Res (Hoboken). 2011 Apr;63(4):579-87. DOI:

Bartoloni E, Pucci G, Cannarile F, Battista F, Alunno A, Giuliani M, et al. Central Hemodynamics and Arterial Stiffness in Systemic Sclerosis. Hypertension. 2016 Dec;68(6):1504-1511. DOI:

Shukla AM, Bose C, Karaduta OK, Apostolov EO, Kaushal GP, Fahmi T, et al. Impact of Hydroxychloroquine on Atherosclerosis and Vascular Stiffness in the Presence of Chronic Kidney Disease. PLoS One. 2015 Sep 28;10(9):e0139226. DOI:

Yilmaz S, Celik G, Esmen SE. Assessment of arterial stiffness in patients with inactive and active Behçet's disease. Scand J Rheumatol. 2014;43(1):63-9. DOI:

Wang XN, Ye P, Cao RH, Yang X, Xiao WK, Zhang Y, et al. Plasma Homocysteine is a Predictive Factor for Arterial Stiffness: A Community-Based 4.8-Year Prospective Study. J Clin Hypertens (Greenwich). 2015 Aug;17(8):594-600. DOI:

Szamosi S, Csiki Z, Szomják E, Szolnoki E, Szoke G, Szekanecz Z, et al. Plasma homocysteine levels, the prevalence of methylenetetrahydrofolate reductase gene C677T polymorphism and macrovascular disorders in systemic sclerosis: risk factors for accelerated macrovascular damage? Clin Rev Allergy Immunol. 2009 Jun;36(2-3):145-9. DOI:

Kabekkodu SP, Mananje SR, Saya RP. A Study on the Role of Heart Type Fatty Acid Binding Protein in the Diagnosis of Acute Myocardial Infarction. J Clin Diagn Res. 2016 Jan;10(1):OC07-10. DOI:

Aslani MR, Ghobadi H, Sarikhani K, Hosseininia S, Sadeghieh-Ahari S. Comparison of Serum Heart-Type Fatty Acid Binding Protein Levels in Stable Chronic Obstructive Pulmonary Disease and Healthy Subjects. Tanaffos. 2020 Jul;19(3):208-15.






Research Article

How to Cite

Öztürk E, Yılmaz S, Tuncez A, Aygül N, Ünlü A, Vatansev H. Is heart-type fatty acid binding protein (H-FABP) a valid marker of arterial stiffness in patients with systemic sclerosis? Arterial stiffness in systemic sclerosis. J Surg Med [Internet]. 2022 Nov. 25 [cited 2024 Apr. 13];6(11):922-5. Available from: