Background. Tenascin-C (TN-C) is an extracellular matrix glycoprotein that appears at sites of inflammation in cardiac pathologies. Aim of the Work. To evaluate the role of TN-C as a marker for active inflammation in children with dilated cardiomyopathy (DCM). Subjects and Methods. 24 consecutive patients with primary nonfamilial DCM aged 6–72 months (mean 45.19 ± 11.03) were divided into group I, twelve patients with acute onset DCM (<6 months duration), and group II, twelve patients with chronic DCM (>6 months duration), and compared to 20 healthy age- and sex-matched controls. Investigations included estimation of serum TN-C and echocardiographic evaluation using M-mode and 2D speckle tracking echocardiography (STE). Results. Serum TN-C showed a higher significant statistical elevation among patients than controls (P < 0.001) and in group I than group II (P < 0.001). EF was significantly decreased, and LVEDD and EDV increased in patients than controls and in GI than GII. STE showed a statistically significant difference in global peak strain longitudinal (GPSL) average in patients than controls (P < 0.05) and between GI and GII (P < 0.001). STE wall motion scoring showed normokinesia (33.5%), hypokinesia (8.33%), and akinesia (50%) in GI and hypokinesia (100%) in GII. There was a statistically significant positive correlation between serum TN-C and GPSL average. Conclusions. Increased serum TN-C can be used as a marker of inflammation in DCM and is associated with the severity of heart failure and LV dysfunction as detected by STE.

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Background Down syndrome (DS), the most common chromosomal abnormality is associated by congenital heart disease (CHD) in (44%) of cases. Children with DS might have different growth pattern compared to children without DS. Objective To assess the impact of congenital heart disease on the growth of Down syndrome children who attend the Genetic clinic, Children’s Hospital, Ain Shams University. Materials and Methods This case controlled study was conducted on 40 children with DS aged 6-36 months and compared to 40 age and sex matched healthy children. The DS children were divided in to two groups, the Cardiac Group: Included 20 DS children with CHD, Non Cardiac Group: 20 DS children without CHD. All children enrolled in the study were subjected to detailed history, thorough clinical examination including (anthropometric measurements (weight, height and HC) and cardiac examination. Results A statistically highly significant decrease was found in children with DS in comparison to normal children in all evaluated anthropometric measurements (P = 0.000) for weight, height, WT/length SDS, head circumference and Z-scores (weight, height and HC).A statistically highly significant decrease was found in DS children with congenital heart disease (cardiac group) in comparison with DS children without congenital heart disease (non-cardiac group) as regards weight (P = 0.002), Height (P = 0.000), head circumference (P = 0.000), Zscores (weight) (P = 0.001) and WT/length SDS (P = 0.001). Conclusion Children with trisomy 21 have well documented growth retardation. Congenital heart diseases have a negative influence on growth pattern in children with DS.