1Mashhour E, 2Tayel M, 3Rowisha M, and 4Abou Freikha M.
Departments of 1Clinical Pathology, 2Cardiology, 3Pediatrics and 4Internal Medicine, Tanta Faculty of Medicine, Tanta University.
The present study aimed to evaluate the role of serum soluble Fas (sFas) “APO-1 receptor”, as an inhibitor of apoptosis (Programmed Cell Death) in children patients suffering from idiopathic dilated cardiomyopathy (IDCM) and its association to New York Heart Association (NYHA) Functional class. The study included 20 children patients aged 5-13 years, suffering from IDCM and 20 age and sex matched control subjects. Serum level of sFas was measured by enzyme linked immunosorbent assay (ELIZA) which showed that sFas is increased significantly with increased NYHA functional class. However, serum levels of sFas were similar in normal subjects and patients with functional class I, but there were significant differences between functional classes II, III and IV. Serum levels of sFas were significantly higher in patients with an elevated pulmonary Capillary Wedge Pressure (PCWP) > 18 mm Hg than in those with values <18 mm Hg. Six months later, all patients were re-evaluated for their functional class and serum sFas levels. Serum levels of sFas decreased in four patients with clinical improvement but were similar in patients with no change in functional class. Conclusion: the increase in sFas may play an important role in the pathophysiologic mechanisms of IDCM in children.