Clinical Study Of The Pathogenetic Significance Of The Apopsis Factors' Mediated By NF-κB In The Chronic Heart Failure

Objective:To investigate the meanings and relationship among NF-κB activation,TNF-αmRNA on perpherial blood mononuclear cells and sFas/sFasL in patients with congestive heart failure,and analyzy the reciprocity of the three factors,the structure of heart and cardiac remodeling by combining together with ultrasonic cardiogram parameters.Method:The 76 patients whith chronic heart failure(CHF)and 30 age and gender matched healthy subject were included in the study.The concentrations of sFas/sFasL in blood srum and activity of NF-κB on perpherial blood mononuclear cells were measured using ELISA assay.The expression of TNF-αmRNA in lymphocytes located in peripheral blood was detected using RT-PCR.We examined the echocardiographic parameters and cardiac function indexes:LAD,IVS,LVDd,LVPW,LVEDV,LVESV,LVEF,LVFS,CO,CI,LVMW,LVMI.Results:1.The concentrations of sFas/sFasL,activity of NF-κB and expression of TNF-αmRNA were siganificiantly higher in CHF patients than those in controls.They increased gradually with the deterioration of cadiac function in CHF patients.(P＜0.01)2,The expression level of TNF-αmRNA and activity of NF-κB presented obviously negative correlation with the parameter of LVEF,CO,CI,The levels of sFas and sFasL presented obviously negative correlation with the parameter of LVEF(r=-0.742).(P＜0.05)3,The level of activity of NF-κB presented obviously positive correlation with the parameters of IVS,LVDd,LVMI.The expression level of TNF-αmRNA presented obviously positive correlation with the parameters of LVDd and LVMI(P ＜0.05).4,The expression level of TNF-αmRNA and activity of NF-κB presented obviously positive correlation in CHF patients.(regression equation y= 0.139+0.004x,r=0.658,P＜0.01)5,The level of activity of NF-κB and sFas/sFasL presented obviously positive correlation(r_sFas=0.594,r_sFasL=0.677),(P＜0.01).Conclusion:1,The concentrations of sFas/sFasL,activity of NF-κB and expression of TNF-αmRNA were siganificiantly rised in CHF patients than those in controls.And presented obviously positive correlation with the parameters of heart remodelin,meanwhile presented obviously negative correlation with the parameter of cadiac function in CHF patients.2,The increasing of activity of NF-κB on perpherial blood mononuclear cells may promote the deteriorating of cadiac function and heart remodling.It may produce a marked effect through the signal transduction pathway of activating TNF—αgene expression in perpherial blood and increasing apopsis associated protein sFas/sFasL.