| Popis: |
Tenascin-C (TN-C), an extracellular matrix glycoprotein, is specifically expressed at high levels during embryonic development, but not in the adult heart. TN-C reappears at sites of inflammatory tissue remodeling or wound healing under various pathologic conditions, such as acute myocardial infarction, acute myocarditis,and some cases of cardiomyopathy. Therefore, the expression of TN-C might be useful for detecting the clinical characteristics of, and ventricular remodeling in, dilated cardiomyopathy (DCM). Objectives: To evaluate the role of TN-C as a sensitive marker for active inflammation in children with newly onset DCM Methods: This case controlled study included 24 patients aged from 6 to 72 months with a mean age 45.19 ± 11.03 compared to 20 age and sex matched healthy children. The subjects were divided into 3 groups. Group 1: included twelve patients with acute onset DCM, (less than 6 months duration) ,Group 2: included twelve patients with established chronic DCM, (more than 6 months duration) and Group 3: twenty (20) healthy age and sex matched children served as control group: all studied patients were subjected to full medical history ,thorough clinical examination. Investigations included: Serum Tenascin-C , chest X-ray and echocardiography using conventional parameters as M-mode, 2D, CW Doppler and 2D speckle tracking technique. Results: The 2D Speckle Tracking data showed that the patients group had lower Global peak Strain Longitudinal Apical long axis( G SL ap lax), G peak SL apical 4 chamber(a4c), G peak SL apical 2 chamber(a2c) and G peak SL average with highly statistical significant difference using T-test. Moreover the global echocariographic assessment showed that acute cases had lower G peak SL ap lax, G peak SL ap4c, G peak SL a2c, G peak SL avg, than the chronic cases with a highly statistically significant difference (P |
