CIRCULATING LEVELS OF sCD40L, sFas, VCAM-1 and ICAM-1 IN ACUTE AND CHRONIC ISCHEMIC HEART FAILURE IN MALE PATIENTS

Document Type : Original Article

Authors

1 Medical Biochemistry Department, Faculty of Medicine, Zagazig University.

2 Clinical Pathology Department, Faculty of Medicine, Cairo University

3 Cardiology Department, Faculty of Medicine, Zagazig University

Abstract

Background and aim of work: Immunomodulatory mediators play a crucial role in
the pathogenesis of heart failure (HF). Vascular cell adhesion molecule-1 (VCAM-1)
and intercellular adhesion molecule-l (ICAM-1) are important inflammatory
mediators of leukocyte adhesion to vascular endothelium and their plasma levles
increase in chronic and acute inflammation. Furthermore, the immune modulators
CD40 ligand (CD40L) and sFas have been receiving increased attention, since they
play a key role in the pathophysiology of multicellular vascular events such as
thrombosis, inflammation, and atherosclerosis. Based on the previous facts, we
planned to evaluate the role of plasma VCAM-1, ICAM-1, and serum soluble CD40L
(sCD40L) and sFas in HF. Subjects and methods: The present study was done on 30
male patients with HF who were classified according to the type of HF to: 15 patients
with chronic HF (CHF) due to ischemic causes and 15 patients with acute myocardial
infarction (AMI) complicated with HF during acute phase (AHF). Ten age-matched
healthy male volunteers were taken as controls. Plasma levels of VCAM-1, ICAM-1,
and serum levels of sCD40L and sFas were measured in all groups. Lipid profile,
creatine phosphokinase and its MB fraction were also measured. Results: There were
significant increase in plasma levels of VCAM-1 (P<0.05), ICAM-1 (P<0.001), and
serum levels of sCD40L (P<0.001) and sFas (P<0.001) in both CHF and AHF
patients compared to control subjects. There was a significant positive correlation
between VCAM-1 and sCD40L, as well as sFas in CHF (r = 0.46, P = 0.03 and r =
0.47, P = 0.02 respectively) and a significant positive correlation between ICAM-1
and sCD40L, as well as sFas in AHF (r = 0.551, P<0.01 and r = 0.49, P = 0.012
respectively). Also, there was a positive significant correlation between sCD40L and
low-density lipoprotein cholesterol in both CHF and AHF cases (P<0.05).
Conclusion: sCD40L, sFas, VCAM-1, and ICAM-1 could be used as markers that
might predict cardiovascular events in patients with chronic and acute heart diseases.

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