الفهرس 
Dilated CardiomyopathyOnly 14 pages are availabe for public view
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Abstract
Cardiomyopathies are heart muscle diseases, which have been defined by their central hemodynamics and macro pathology and divided in five major forms: dilated (DCM), hypertrophic (HCM), restrictive (RCM), right ventricular (RVCM), and no classifiable cardiomyopathies (NCCM). Inflammation has been recognized as a hallmark of heart failure with levels of circulating and cardiac proinflammatory cytokines indicating heart failure severity in humans. Based on this inflammatory response to damaged myocardium, some researchers formulated the cytokine hypothesis, which holds that proinflammatory cytokines are produced by the damaged myocardium during chronic heart failure and that this inflammatory response promotes monocyte activation and the further production of cytokines, thus augmenting cardiac dysfunction. In most cases, inflammation occurs naturally in response to injury to promote tissue repair. However, an overwhelming inflammatory response may trigger further tissue damage and disease. In recent years, clinical significance of some biomarkers in prognosis of dilated cardiomyopathy patients such as N-Terminal Pro-Brain Peptides (NT-pro-BNP), High-sensitivity Troponin T and Neutral Gelatinase-associated Lipocan. B7-H3 is newly found member of the B7 family, which plays a crucial role in the T cell-mediated immune response. It is thought that B7-H3 is associated with immune stress development. Recently, B7 -H3 is also reported to be related to immune stress in pediatric patients.
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So, the study aimed to measure serum level of B7-H3 in children with cardiomyopathy as prognostic factor for heart failure and to correlate it with severity of heart failure in those children.
To elucidate our aim, the present study was carried out on 50 pediatric patients with cardiomyopathy, apparently normal 40 children of comparable age, sex, and socioeconomic status was taken as control group. All children were be divided into 2 groups group 1:formed from 50 dilated cardiomyopathy children ,30 male and 20 female. group 2 : control group, 40 healthy children , matched in age and sex. All children were be taken from pediatric department in Menoufia University and Shebin El-Kom Teaching hospital. Results of the current study could be summarized as follow:
There was no significantly differences among the studied group regarding age and sex (P>0.05). Also, 6% of cases had positive family history. Heart rate and systolic blood pressure were significantly increased among cases group than control group (P<0.001). While, there was no significant differences among the studied group regarding respiratory rate and diastolic blood pressure
There was no significant differences among the studied groups regarding weight, height and body mass index.
Hemoglobin was significantly decreased among cases group than control group (P<0.001). While, white blood cells were significantly increased among cases group than control group (P<0.001). While, there were no significant differences among the studied group regarding platelet and RBCs (P>0.001). On the
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other hand, most of cases had negative C-reactive protein (66%).
There was significant differences among the studied groups regarding as LVEDD(3.4±0.69 ) and LVESD (3.29 ±0.75), But there was significant decrease as regard EF(30.30 ±2.78) and FS %(20.86 ±3.52)in cases group than control group.
BNP and B7H3 were significantly increased among cases groups (96.71±39.57, 155.90±80.07) than control group (10.66±6.45 and 22.02±15.76), (P<0.001).
BNP and B7H3 was significantly increased among modified Ross score III- IV group (92.10±40.23, 162.44±97.84) than modified Ross score I-II group (73.055±39.12, 155.345±79.47), (P<0.05).
There was positive significant correlations between BNP and B7H3 with heart rate, M. ROSS Score and negative significant correlations with LVEDD , LVESD ,Ejection fraction, fractional shortening % (P<0.05) but no correlation with age , family history, respiratory rate, blood pressure , body mass index .
ROC curve analysis showed that BNP and B7H3 were possible methods for detection its level as marker of dilated cardiomyopathy, it had sensitivity of 90%, specificity of 52% at AUC of 0.975 with cut off value 19.21pg/ml as compared B7H3 that had sensitivity of 79%, specificity of 42% at AUC of 0.969 with cut off value 30.72ng/ml.