aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАН10.52727/2078-256X-2026-22-2-243-259ateroskleroz-1199Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSКлинико-диагностическое значение сердечного белка, связывающего жирные кислоты (H-FABP), в кардиологической практикеClinical and diagnostic significance of heart fatty acid-binding protein (H-FABP) in cardiological practicehttps://orcid.org/0000-0001-9023-6137ЮсупхаджиеваЛ. М.YusupkhadzhievaL. M.

Линда Мовсаровна Юсупхаджиева, аспирант 1-го года обучения; врач-кардиолог

628412, г. Сургут, пр. Ленина, 1

628416, г. Сургут, пр. Ленина, 69/1

Linda M. Yusupkhadzhieva, 1st-year postgraduate student; cardiologist

1, Lenina ave., Surgut, 628412

9/1, Lenina ave., Surgut, 628416

linda8695@mail.ruhttps://orcid.org/0000-0002-5545-9826УрванцеваИ. А.UrvantsevaI. A.

Ирина Александровна Урванцева, канд. мед. наук, доцент, зав. кафедрой кардиологии; главный врач

628416, г. Сургут, пр. Ленина, 69/1

628412, г. Сургут, пр. Ленина, 1

Irina A. Urvantseva,chief physician; candidate of medical sciences, associate professor, head of the department of cardiology

69/1, Lenina ave., Surgut, 628416

1, Lenina ave., Surgut, 628412

priem@cardioc.ruhttps://orcid.org/0000-0001-7014-2096ВоробьевА. С.VorobyovA. S.

Антон Сергеевич Воробьев, врач-кардиолог отдела госпитализации с телемедицинским центром; канд. мед. наук, доцент, зам. зав. кафедрой кардиологии, ведущий научный сотрудник; научный сотрудник лаборатории неотложной терапии НИИТПМ – филиал ИЦиГ СО РАН

628416, г. Сургут, пр. Ленина, 69/1

628412, г. Сургут, пр. Ленина, 1

630089, г. Новосибирск, ул. Бориса Богаткова, 175/1

Anton S. Vorobyov, cardiologist, hospitalization department with telemedicine center; candidate of medical sciences, associate professor, deputy head of the cardiology department, leading researcher, scientific and educational center; researcher, laboratory of emergency therapy

69/1, Lenina ave., Surgut, 628416

1, Lenina ave., Surgut, 628412

175/1, Borisa Bogatkova st., Novosibirsk, 630089

a.s.vorobyov@gmail.comhttps://orcid.org/0009-0005-5332-1910КудрявцеваО. В.KudryavtsevaO. V.

Ольга Валерьевна Кудрявцева, канд. мед. наук, зав. консультативным отделением

628416, г. Сургут, пр. Ленина, 69/1

Olga V. Kudryavtseva, candidate of medical sciences, head of the consultative department

69/1, Lenina ave., Surgut, 628416

kov@cardioc.ruhttps://orcid.org/0009-0002-6233-2353ОсмановаН. Б.OsmanovaN. B.

Надина Байрамовна Османова, врач-кардиолог высшей квалификационной категории, зав. приемным отделением

628416, г. Сургут, пр. Ленина, 69/1

Nadina B. Osmanova, cardiologist of the highest qualification category, head of the emergency department

69/1, Lenina ave., Surgut, 628416

Osmanova@cardioc.ruhttps://orcid.org/0000-0003-4601-6203НиколаевК. Ю.NikolaevK. Yu.

Константин Юрьевич Николаев, д-р мед. наук, проф., зав. лабораторией неотложной терапии НИИТПМ – филиал ФИЦ ИЦиГ СО РАН; проф. кафедры факультетской терапии; проф. кафедры кардиологии

628412, г. Сургут, пр. Ленина, 1

630089, г. Новосибирск, ул. Бориса Богаткова, 175/1

630090, г. Новосибирск, ул. Пирогова, 2

Konstantin Yu. Nikolaev, doctor of medical sciences, professor, head of the laboratory of emergency therapy; professor at the department of faculty therapy; professor at the department of cardiology

1, Lenina ave., Surgut, 628412

175/1, Borisa Bogatkova st., Novosibirsk, 630089

2, Pirogova st., Novosibirsk, 630090

nikolaevky@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Сургутский государственный университет»; Бюджетное учреждение ХМАО-Югры «Окружной кардиологический диспансер «Центр диагностики и сердечно-сосудистой хирургии»Surgut State University; Khanty-Mansiysk Autonomous Okrug – Yugra Institution “District Cardiology Dispensary «Center for Diagnostics and Cardiovascular Surgery»Бюджетное учреждение ХМАО-Югры «Окружной кардиологический диспансер «Центр диагностики и сердечно-сосудистой хирургии»; Медицинский институт Сургутского государственного университетаKhanty-Mansiysk Autonomous Okrug – Yugra Institution “District Cardiology Dispensary «Center for Diagnostics and Cardiovascular Surgery»; Surgut State University Medical InstituteБюджетное учреждение ХМАО-Югры «Окружной кардиологический диспансер «Центр диагностики и сердечно-сосудистой хирургии»; Медицинский институт Сургутского государственного университета; Научно-исследовательский институт терапии и профилактической медицины – филиал Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»Khanty-Mansiysk Autonomous Okrug – Yugra Institution “District Cardiology Dispensary «Center for Diagnostics and Cardiovascular Surgery»; Surgut State University Medical Institute; Research Institute of Therapy and Preventive Medicine – Branch of the Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of SciencesБюджетное учреждение ХМАО-Югры «Окружной кардиологический диспансер «Центр диагностики и сердечно-сосудистой хирургии»Khanty-Mansiysk Autonomous Okrug – Yugra Institution “District Cardiology Dispensary «Center for Diagnostics and Cardiovascular Surgery»Федеральное государственное бюджетное образовательное учреждение высшего образования «Сургутский государственный университет»; Научно-исследовательский институт терапии и профилактической медицины – филиал Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»; Федеральное государственное бюджетное образовательное учреждение высшего образования «Новосибирский национальный исследовательский государственный университет»Surgut State University; Research Institute of Therapy and Preventive Medicine – Branch of the Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences; Novosibirsk National Research State University202630062026222243259Copyright © Юсупхаджиева Л.М., Урванцева И.А., Воробьев А.С., Кудрявцева О.В., Османова Н.Б., Николаев К.Ю., 20262026Юсупхаджиева Л.М., Урванцева И.А., Воробьев А.С., Кудрявцева О.В., Османова Н.Б., Николаев К.Ю.Yusupkhadzhieva L.M., Urvantseva I.A., Vorobyov A.S., Kudryavtseva O.V., Osmanova N.B., Nikolaev K.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ateroskleroz.elpub.ru/jour/article/view/1199

Цель исследования – обобщить и систематизировать современные данные о молекулярных функциях сердечного белка, связывающего жирные кислоты (H-FABP), его роли в ранней диагностике острого коронарного синдрома (ОКС) и прогностической значимости при стабильной ишемической болезни сердца (ИБС) и хронической сердечной недостаточности (ХСН). Материал и методы. Проведен систематический поиск литературы в базах данных PubMed, Scopus, Web of Science, eLibrary за период с 1972 по 2025 г. Ключевые слова: «heart-type fatty acid-binding protein», «H-FABP», «FABP3», «acute myocardial infarction», «stable coronary artery disease», «heart failure», «biomarker», «prognosis». Отобраны оригинальные клинические исследования, метаанализы и систематические обзоры, посвященные диагностической и прогностической ценности H-FABP. Результаты. H-FABP – низкомолекулярный цитозольный белок (15 кДа), обеспечивающий внутриклеточный транспорт длинноцепочечных жирных кислот в кардиомиоцитах. Благодаря быстрому высвобождению при повреждении мембраны он появляется в крови уже через 1–3 ч от начала повреждения кардиомиоцитов, достигая пика к 6–8 ч, что делает его наиболее чувствительным маркером в первые часы острого коронарного синдрома (чувствительность > 90 %, отрицательная прогностическая ценность до 99 %). При ОКС повышение H-FABP (> 8 нг/мл) ассоциировано с 4–5-кратным увеличением риска смерти, повторного инфаркта и сердечной недостаточности в течение года. У пациентов со стабильной ИБС стойкое повышение H-FABP (пороги 2,7–4,5 нг/мл) отражает субклиническое повреждение миокарда вследствие микрососудистой дисфункции, воспаления и метаболического стресса и служит независимым предиктором сердечно-сосудистых событий в сроки до 7 лет (относительный риск (ОР) 2,5–5,0). При ХСН концентрация H-FABP коррелирует с функциональным классом NYHA, а его комбинация с NT-proBNP улучшает стратификацию риска смерти и госпитализаций (ОР до 5,68). При тромбоэмболии легочной артерии (ТЭЛА) уровень H-FABP ≥ 6 нг/мл предсказывает 30-дневные осложнения с ОР 10,04, превосходя тропонины и NT-proBNP. Заключение. H-FABP представляет собой уникальный биомаркер с двойной клинической перспективой: сверхранняя диагностика острого повреждения миокарда и долгосрочная стратификация риска при хронических формах ИБС и ХСН. Для внедрения в широкую практику необходима стандартизация пороговых значений и изучение влияния на терапевтическую тактику.

Objective: to summarize and systematize current data on the molecular functions of heart-type fatty acid-binding protein (H-FABP), its role in early diagnosis of acute coronary syndrome (ACS) and prognostic value in stable coronary artery disease (CAD) and chronic heart failure (CHF). Material and methods. A systematic literature search was performed in PubMed, Scopus, Web of Science, eLibrary databases from 1972 to 2025. Keywords: «heart-type fatty acid-binding protein», «H-FABP», «FABP3», «acute myocardial infarction», «stable coronary artery disease», «heart failure», «biomarker», «prognosis». Original clinical studies, meta-analyses and systematic reviews on diagnostic and prognostic value of H-FABP were selected. Results. H-FABP is a low-molecular-weight cytosolic protein (15 kDa) that mediates intracellular transport of long-chain fatty acids in cardiomyocytes. Due to rapid release upon membrane damage, it appears in blood within 1–3 h after coronary occlusion, peaks at 6–8 h, making it the most sensitive marker in the first hours of ACS (sensitivity > 90 %, negative predictive value up to 99 %). In ACS, elevated H-FABP (> 8 ng/mL) is associated with a 4–10-fold increased risk of death, recurrent infarction and heart failure within one year. In stable CAD patients, persistent elevation of H-FABP (cutoffs 2.7–4.5 ng/mL) reflects subclinical myocardial injury due to microvascular dysfunction, inflammation and metabolic stress and serves as an independent predictor of cardiovascular events up to 7 years (HR 2.5–5.0). In CHF, H-FABP concentration correlates with NYHA functional class, and its combination with NT-proBNP improves risk stratification for death and hospitalization (HR up to 5.68). In pulmonary embolism, H-FABP ≥ 6 ng/mL predicts 30-day complications with HR 10.04, outperforming troponins and NT-proBNP. Conclusions. H-FABP is a unique biomarker with dual clinical perspective: ultra-early diagnosis of acute myocardial injury and long-term risk stratification in chronic CAD and CHF. Standardization of cutoffs and investigation of its impact on therapeutic management are needed for widespread clinical implementation.

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The authors declare that there are no conflicts of interest present.