Introduction: Evaluation of the role of rehabilitation treatment in decreasing the value of the heart – fatty acid-binding protein (H-FABP) compared to classical biomarkers in patients with chronic kidney disease versus those with preserved renal function, both groups of patients benefiting of cardiac rehabilitation treatment after coronary artery bypass grafting (CABG).
Methods: T he prospective study included 120 patients admitted to the Iasi Cardiovascular Institute and later in the Clinical Recovery Hospital of Iasi between 01.05.2016 and 01.05.2017. Inclusion criteria: Post CABG patients (<1 week), age 40-80 years. Exclusion criteria: mental illness, physical disability and cancer. Patients were followed by gender, age, general clinical examination, H-FABP value, renal function, echocardiographic evaluation (LVDd, IVSd, LVWd, EF, SF) and monitoring in a kinetotherapy program. The statistical analysis was performed in SPSS.
Results: The study highlighted the role of early reco-very program therapy in reducing plasma H-FABP levels. The mean H-FABP in phase I was 67.40±9.81 ng/ml, and 4.80±2.30 ng/ml in Phase III (p<0.05). We acknowledged the improvement in post-CABG symp-tomatology, and of echocardiographic data, supported by the increase of the EF (from 43% to 52%), and of the shortening fraction (SF rose from 25% to 27%), the improvement of blood pressure control (systolic blood pressure decreased from 160 mmHg to 120 mmHg) and the improvement in exercise capacity (from 2-3 METs to 4-5 METs). For patients with chronic kidney disease (29.1% of cases), the reduction in H-FABP had a higher level of similarity, compared to patients with normal renal function. But the difference between the postoperative and third phase of the rehabilitation pro-gram was 10 points more important for normal renal function, with a median of total values of 60.1. For normal kidney function, the upper and lower limits have been more variable in range than in patients with chronic renal disease.
Conclusions: T his research demonstrates the role of the postoperative rehabilitation program in reducing the H-FABP protein value regardless of the degree of renal impairment, with less variability in case of chronic kidney disease than in patients with preserved renal function. Improvement of H-FABP values has influenced the reduction of postoperative complications, improved quality of life, cardiac and renal function, and reversibility of the atherosclerotic process evidenced by improved metabolic processes.