Serum levels of soluble Fas in children with congestive heart failure

ABSTRACT

This study was done to investigate the role of apoptosis [programmed cell death] in children with congestive heart failure [CHF]. Serum levels of soluble Fas [sFas], an inhibitor of apoptosis was estimated in 30 children with CHF, 10 due to rheumatic heart disease [RHD], 10 due to congenital ventricular septal defect [VSD] and 10 due to idiopathic dilated cardiomyopathy [IDCM]. The children included were 20 males and 10 females, aged between 7 to 14 years. The diagnosis was based on thorough clinical and echo-Doppler examinations. They were classified according to the New York Heart Association [NYHA] functional class based on their clinical characteristics. Ten normal healthy children with matched age and sex served as a control group. Our results showed that there was a significant increase in serum levels of sFas in children with CHF as compared to the control group. There was a significant positive correlation between serum levels of sFas and NYHA functional class. Serum levels of sFas were correlated with certain echo-Doppler parameters that reflect the severity of CHF resulting in a significant positive correlation with pulmonary wedge pressure [PWP] and a significant negative correlation with ejection fraction [EF]. The increase in serum levels of sFas was related to the severity of CHF independently of the underlying cardiac disease. Serum levels of sFas tended to decrease significantly in children with CHF who underwent clinical improvement but not significantly changed in the stable cases during the six months follow up. There was no significant difference in serum levels of sFas between the survivors and those children who died. In conclusion: serum levels of sFas, an inhibitor of apoptosis may play an important role in the pathophysiologic mechanisms of CHF in children