الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Heart failure is a condition in which the heart does not pump enough br blood to meet the needs of the body’s tissues. Heart failure can develop br slowly over time as the result of other conditions (such as high blood br pressure and coronary artery disease) that weaken the heart. It can also occur br suddenly as a result of damage to the heart muscle. br Chronic Heart failure and chronic kidney disease share a number of br risk factors and pathophysiological pathways. These two pathological br processes coexist in large numbers of patients. br The presence of chronic kidney disease (CKD) in patients with heart br failure adversely influences their survival. Cardiovascular disease is the br major cause of mortality in individuals with chronic kidney disease and on br the other hand renal insufficiency is common in patients with chronic heart br failure. br Lipocalin-2 is 25 kDa glycoprotein first isolated -#102;-#114;-#111;-#109; granular br polymorphnuclear leukocytes. br Lipocalin-2 is one of the most highly expressed proteins following br ischemia-reperfusion injury in kidney cells, and prognostic of kidney br damage long before more traditional marker (creatinine) was raised br significantly. This has led to considerable interest in this protein, especially br as a marker of renal injury, and perhaps as a therapeutic monitoring factor. br The current study was carried out at the Medical Biochemistry and br Cardiology Departments, Faculty of Medicine, Menoufiya University. br The aim of this work is to assess whether lipocalin-2 could represent a br novel, sensitive marker of kidney function in patients with chronic ischemic br heart failure (IHF). The current study involved 45 individuals: 35 patients br with chronic IHF divided into two subgroups according to creatinine br clearance [15 subjects with normal creatinine clearance (≥ 80 ml/min) and br 20 subjects with low creatinine clearance(-lt; 80 ml/min)] and 10 age and sex br matched healthy subjects served as controls. br Full history and clinical examination were made to every subject. br Echocardiography and laboratory investigations including complete blood br count, serum albumin, urea and creatinine, lipid profile (total cholesterol, br triglycerides, high density lipoprotein cholesterol, HDLc and low density br lipoprotein cholesterol, LDLc), serum and urinary lipocalin-2 were also br carried out to all individuals. br The results of the present study can be summerized as follows: br • Smoking and diabetes mellitus are significantly higher among patients br with chronic ischemic heart failure (IHF) than controls. br • Systolic blood pressure is significantly higher among patients with br chronic IHF than controls and also significantly higher in subgroup IB br (chronic IHF patients with low creatinine clearance) when compared br to subgroup IA (chronic IHF patients with normal creatinine br clearance). br • Regarding echocardiography, there is significant increase as regarding br end diastolic diameter and end systolic diameter in patients when br compared to controls, while there is a significant decrease as br regarding ejection fraction in patients when compared to controls. br • Serum urea and creatinine are significantly higher in patients with br chronic IHF when compared to controls, while creatinine clearance br and serum albumin are significantly lower in patients when compared br to controls. br • There is a high significant increase as regarding total cholesterol, br triglycerides and LDL in chronic IHF patients when compared to br controls, while there is a high significant decrease as regarding HDL br in patients when compared to controls. br • Serum - urinary lipocalin-2 are significantly higher in chronic IHF br patients when compared to controls. br • Serum creatinine is significantly higher in subgroup IB (chronic IHF br with low creatinine clearance) when compared to subgroup IA br (chronic IHF with normal creatinine clearance), while serum albumin br is significantly lower in subgroup IB when compared to subgroup IA. br • There is a high significant increase as regarding serum and urinary br lipocalin-2 in subgroup IB when compared to subgroup IA. br • There is significant positive correlation of serum lipocalin-2 with br serum creatinine, NYHA class and urinary lipocalin-2, while there is br negative correlation with serum albumin and creatinine clearance. br • There is significant positive correlation of urinary lipocalin-2 with br serum creatinine, NYHA class and serum lipocalin-2, while there is br significant negative correlation with creatinine clearance and serum br albumin. br • Serum creatinine show significant negative correlation with creatinine br clearance.