Serum Oxidative Stress Level Correlates with Clinical Parameters in Chronic Systolic Heart Failure Patients

Abstract

Background: Serum oxidative stress (OS) level has an important role in the inflammatory process of heart failure. Hypothesis:The study was designed to analyze serum OS levels in chronic heart failure (HF) patients and to examine the relation between OS levels and other clinical and prognostic parameters of HF. Methods: We studied 82 consecutive chronic symptomatic HF patients with systolic LV dysfunction (ejection fraction < 45%). The serum OS level was determined using thermochemiluminescence assay. We compared the serum OS levels with patients' clinical and prognostic parameters. Results: Higher serum OS levels were associated with higher New York Heart Association class (P = .01), worse renal function (serum urea, creatinine, and creatinine clearance) (P<.001) and higher serum levels of hs-C-reactive protein and N-terminal pro brain natriuretic peptide (P = .001, P<.001, respectively). Conclusions: In chronic systolic HF patients, high serum OS levels correlate with advanced disease and known markers of poor prognosis. IntroductionHeart failure (HF) is a major cardiovascular health problem, associated with high mortality and morbidity. Several studies suggested that inflammation has an important role in HF progression. Serum oxidative stress (OS) level is a crucial element of the inflammatory process, owing to the accumulation of reactive oxygen/nitrogen species that might provoke and exacerbate the myocardial damage of the already failing heart. 1 Several medications claim to have at least some beneficial effects through the antioxidant potential. 2 -6 The thermochemiluminescence (TCL) oxidiziability assay (Lumitest Ltd., Haifa, Israel), measures the OS level via photon emission counting from excited carbonyls in biological macromolecules. 7 TCL measurements were previously compared to other well accepted methods, which measure serum oxidative stress level via oxidation of lipids or proteins. 8 As we demonstrated before, TCL measurements were highly correlated with thiobarbituric acid reactive substances-(TBA assay), as well as with protein carbonyl formation (r = 0.99, r = 0.98, P<.01, respectively). 7 In this study, we investigated serum OS levels in chronic HF patients and examined the relation between OS levels and other clinical and laboratory prognostic parameters.

Isoproterenol disperses distribution of NADPH oxidase, MMP-9, and pPKCε in the heart, which are mitigated by endothelin receptor antagonist CPU0213

“…Given accumulated data that oxidative lesion is a primary causal factor in inducing arrhythmias [36] , our data further suggest that dispersed upregulation of expression of NADPH oxidase may intimately participate in arrhythmogenesis and compromised cardiac performance as well [37] . Thus, heterogeneity in expression of NADPH oxidase between the LV, septum and RV confers a basic entity of vulnerable myocardium produced by sustained β-adrenergic receptor activation.…”

Serum oxidizability potential is associated with age and exercise test results

“…The TCL assay used in our study is one among the accepted, validated, and reproducible methods [9][10][11] for measurement of oxidative stress and serum oxidizability potential. This assay is based on the heat-induced oxidation of a sample leading to the formation of electronically excited species (in particular of triplet excited carbonyls) and of light energy, low-level chemiluminescence.…”

“…Evidence for increased oxidative stress has been found in plasma of patients with ischemic and nonischemic cardiomyopathy and correlates directly with the severity and chronicity of symptoms, and inversely with left ventricular ejection fraction (LVEF) [11,12].…”

Serum oxidizability potential of ischemic heart disease patients is associated with exercise test results and disease severity

“…These potentially deleterious reactions can result in profound cellular dysfunction and even cytotoxicity [4] . Recent data imply that measurement of oxidizability is a key to kinetic evaluation of oxidative processes of LDL, blood serum and other body fluids, and can be used for monitoring the oxidative stress in different diseases and antioxidant drug therapy [5][6][7][8][9] . The oxidizability of a biological sample is a measure of its susceptibility to oxidation.…”

“…Evidence for increased oxidative stress has been found in plasma of patients with ischemic and nonischemic dilated cardiomyopathy and correlates directly with the severity and chronicity of symptoms, and inversely with left ventricular ejection fraction (LVEF) [11,12] . Free radical injury has also been implicated in the pathogenesis, evolution and progression of heart failure [9,[13][14][15] . Furthermore, with the evolution of heart failure, there is a progressive increase in free radical injury and reduction of antioxidant reserves, which impacts significantly on prognosis.…”