Analysis of levels of oxidative stress markers depending on the left ventricular ejection fraction in patients with chronic heart failure

Abstract

Aim.To study and analyze the levels of oxidative stress (OS) markers (malondialdehyde (MDA), superoxide dismutase (SOD), advanced oxidation protein products (AOPPs)) depending on the left ventricular ejection fraction (LVEF) and functional class (FC) in patients with chronic heart failure (CHF).Material and methods.We examined 60 somatically healthy individuals and 345 patients with CHF, which were divided into three main groups depending on the LVEF and subgroups depending on FC. The levels of OS markers were determined in blood serum — MDA, SOD and AOPPs.Results.In the group of patients with preserved LVEF and FC II-IV CHF, levels of MDA and AOPPs were statistically significantly higher, and the SOD level was lower compared to the control group. In the group of patients with moderately reduced and reduced LVEF, the levels of MDA and AOPPs were statistically significantly higher, and SOD activity was lower compared with the control group and the group of patients with CHF and preserved LVEF. In patients with CHF with higher FC, there was a statistically significant increase of MDA and AOPPs levels and decrease of SOD activity. The most pronounced changes in the levels of above-mentioned markers were recorded in patients with reduced LVEF. According to the correlation analysis a direct relationship between the levels of markers of the OS and clinical manifestations of the disease was found.Conclusion.Changes in levels of MDA, SOD and AOPPs in patients with CHF were detected already in the early stages of the disease compared with the control group. In patients with higher FC CHF and preserved, moderately reduced and reduced LVEF, a statistically significant increase in the levels of MDA and AOPPs and a decrease of SOD activity were observed. The most pronounced changes in the levels of the markers were indicated in patients with reduced LVEF.

Low-intensity inflammation as a manifestation of comorbidity and a factor in the unfavorable clinical course of heart failure with preserved ejection fraction

“…При этом влияние коморбидной патологии на клиническое течение и прогноз заболевания у больных с данным фенотипом ХСН на сегодняшний день сомнений не вызывает. Согласно современным представлениям, хроническое низкоинтенсивное воспаление в условиях влияния коморбидных состояний, таких, как ожирение, артериальная гипертензия и СД 2 типа, способствует развитию эндотелиальной дисфункции и окислительного стресса, что относят к одним из основных механизмов развития СНсФВ [14]. Более частое выявление нарушений углеводного обмена в группе с неблагоприятным течением СНсФВ, обнаруженное в настоящем исследовании, соответствует данным литературы [15,16], согласно которым дисфункция эндотелия обнаруживается задолго до установления диагноза СД 2 типа у пациента, в том числе при НТГ, вероятно, вследствие длительного периода латентной инсулинорезистентности и гипергликемии [17].…”