Relationship between plasma levels of cardiac natriuretic peptides and soluble Fas: Plasma soluble Fas as a prognostic predictor in patients with congestive heart failure

Abstract

Background: Cardiac natriuretic peptides may induce apoptosis in myocytes; however, the relationship between plasma levels of cardiac natriuretic peptides and those of soluble Fas (sFas) and tumor necrosis factor (TNF)-α remains unknown in patients with congestive heart failure (CHF). Methods and Results: We measured plasma levels of sFas and TNF-α and those of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), norepinephrine, and endothelin 1 in 96 patients with CHF (ejection fraction < 45%). The patients were monitored for 3 years. Plasma levels of sFas and TNF-α increased with the severity of CHF. There was no significant correlation between sFas plasma levels and those of ANP and BNP. Cox proportional hazard analysis showed that high levels of sFas (P =.009) and BNP (P <.0001) and a low ejection fraction (P =.019) were independent significant prognostic predictors. Conclusions: There is no significant correlation between cardiac natriuretic peptide and sFas levels in plasma. Plasma sFas is a useful prognostic marker independent of neurohumoral factors, suggesting that immune activation and/or apoptosis play a significant role in the pathogenesis of CHF.