The Change And Its Significance Of Plasma Levels Of SFas And SFasL In Patients With Chronic Heart Failure

OBJECTIVES: This study is to observe the plasma levels of soluble Fas (sFas), an inhibitor of apoptosis, and soluble Pras ligand (sFasL), an inducer of apoptosis , and the relationship between them in the patients with chronic heart failure (CHF), and to evaluate the significance of sFas and sFasL in the development of heart failure.METHODS: The study included 111 patients (average 49 years, ranging from 28 to 90) with New York Heart Association(NYHA) classified II-IV chronic CHF (coronary artery disease in 51, dilated cardiomyopathy in 9, valvular heart disease in 32, hypertensive heart disease in 19 and 20 age-and-gender-matched normal control subjects). Plasma levels of sFas and sFasL were measured by enzyme-linked immunosorbent assays using monoclonal anti-human antibodies. The patients were monitored either by telephone or by correspondence every three months, the end point of which were cardiac death or noncardiac death.RESULTS: There were significant differences in sFas and sFasL levels between normal subjects and patients with CHF(p<0.01); independent on the underlying diseases and the index of left ventricular myocardium (LVMI), but dependent on the ejective fraction(EF) and the left ventricular diastolic diameter (LVDd). Plasma levels of sFas increased with severity of functional classification and had significantcorrelation with heart functional classification (p<0.01). 98 patients were monitored in the average of 19.0±13.6 months. There was a positivecorrelation between the time of survival and EF, and a negative correlation between the time of survival and sFas (P<0.05). The rate of survival in the group of sFas<3.01ng/ml was higher than that of sFas>3.01ng/ml, and that of EF>0.35 was also higher than that of EF<0.35(P<0.05). The levels of sFas in nonsurvivors were significantly higher than in survivors (P<0.05).CONCLUSIONS: Compared with controls, we found elevated levels of plasma sFas and sFasL increased clearly in patients with CHF, which suggests the increase of sFas and sFasL levels in human CHF may play an important role in the pathophysiologic mechanism of CHF. Plasma sFas may be a useful prognostic marker in patients with CHF.