Ongoing Myocardial Damage in Chronic Heart Failure is Related to Activated Tumor Necrosis Factor and Fas/Fas Ligand System

概要

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Background Elevated concentrations of cardiac troponin T and heart-type fatty acid-binding protein (H-FABP) identify patients with chronic heart failure (CHF) and ongoing myocardial damage (OMD) who are at increased risk for future cardiac events. Cardiomyocyte necrosis and/or apoptosis via activated tumor necrosis factor (TNF) and the Fas/Fas ligand (FasL) system may be related to the development of OMD. Methods and Results The serum concentrations of H-FABP, a sensitive marker of membrane damage of cardiomyocytes, soluble Fas (sFas) and TNF-α were measured in 38 patients with CHF. The concentrations of H-FABP, TNF-α and s-Fas in patients with New York Heart Association (NYHA) III+IV were all significantly higher than in those patients in NYHA II (H-FABP; III+IV 9.3±5.9 vs II 5.1±1.8ng/ml, p=0.003, TNF-α; III+IV 10.5±3.8 vs E 8.0±2.7pg/ml, p=0.02, sFas; III+IV 3.36±1.37 vs II 2.58±0.84ng/ml, p=0.03). Increased concentrations of H-FABP significantly correlated with the concentrations of TNF-α (r=0.57, p=0.0001) and sFas (r=0.69, p<0.0001), independent of renal function. Conclusion OMD detected by H-FABP, a marker of membrane damage, is related to activated TNF and the Fas/FasL system, which suggests a pathophysiological role of cardiomyocyte necrosis and/or apoptosis in patients with worsening heart failure.
2004-07-20