Association between the level of soluble markers of Fas/FasL apoptosis system and heart failure

¯Abstract Background: Heart failure is the main cause of morbidity and mortality worldwide with poor prognosis. Two processes inflammation and apoptosis, play major roles in the pathogenesis of heart failure with poor prognosis. Apoptosis can be discovered in different conditions within the myocardial tissues. One of the regulatory mechanisms of apoptosis is through Fas (CD95)/FasL system. Objective: Evaluating the level of soluble markers of Fas/FasL apoptosis system in patients with heart failure and its severity. Methods: This was a case-control study in which 85 patients with different functional class of heart failure and 25 healthy persons as control group were examined at Transplantation Institute of Moscow between the years 2004-2007. Evaluation of apoptosis markers was carried out by immunoferment analysis using an automatic analyzer (Personal Lab TM, Adaltis, Italy) and the Bender Med system kits, Austria. Findings: In patients with heart failure while the blood level of sFas was lower than that of healthy person, the sFasL was found to be higher compared to control group. Regarding the level of soluble forms of apoptotic markers of sFas/sFasL in HF, the sFas and sFasL levels were demonstrated to have an opposite association with the functional class of heart failure so that a negative relationship for sFas and a positive correlation for sFasL were found. At the same time, the sFas was shown to be weakly associated with ejection fraction whereas the sFasL demonstrated a reverse correlation (P<0.05). Conclusion: These markers could be used as complementary laboratory markers to assess the severity of heart failure and also the prognosis.