title: Urinary biopyrrins levels are elevated in relation to severity of heart failure.
abstract: OBJECTIVE
  We investigated the relationship between the urinary levels of biopyrrins and the severity of heart failure (HF).
  
  
  BACKGROUND
  Oxidative stress is evident in heart disease and contributes to the development of ventricular dysfunction in patients with HF. Biopyrrins, oxidative metabolites of bilirubin, have been discovered as potential markers of oxidative stress.
  
  
  METHODS
  We measured the levels of urinary biopyrrins and plasma B-type natriuretic peptide (BNP) in 94 patients with HF (59 men; mean age 65 years) and 47 control subjects (30 men; mean age 65 years). Urine and blood samples were taken after admission in all subjects. Further urine samples were obtained from 40 patients after treatment of HF.
  
  
  RESULTS
  The urinary biopyrrins/creatinine levels (micromol/g creatinine) were the highest in patients in New York Heart Association (NYHA) class III/IV (n = 26; 17.05 [range 7.85 to 42.91]). The urinary biopyrrins/creatinine levels in patients in NYHA class I (n = 35; 3.46 [range 2.60 to 5.42]) or II (n = 33; 5.39 [range 3.37 to 9.36]) were significantly higher than those in controls (2.38 [range 1.57 to 3.15]). There were significant differences in urinary biopyrrins/creatinine levels among each group. The treatment of HF significantly decreased both urinary biopyrrins/creatinine levels (from 7.43 [range 3.84 to 17.05] to 3.07 [range 2.21 to 5.71]) and NYHA class (from 2.5 +/- 0.1 to 1.7 +/- 0.1). Log biopyrrins/creatinine levels were positively correlated with log BNP levels (r = 0.650, p < 0.001).
  
  
  CONCLUSIONS
  These results indicate that urinary biopyrrins levels are increased in patients with HF and are elevated in proportion to its severity.
authors.affiliation: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hokamaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawano
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Soejima
authors.forename: Shinzo
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kajiwara
authors.forename: Sunao
authors.initials: S
authors.lastname: Kojima
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Seigo
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hirai
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimomura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagayoshi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tsujita
authors.forename: Izuru
authors.initials: I
authors.lastname: Shioji
authors.forename: Shinya
authors.initials: S
authors.lastname: Sasaki
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D001663:Bilirubin / Q000378:metabolism; D015415:Biomarkers / Q000097:blood / Q000652:urine; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000503:physiopathology* / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000652:urine; D018384:Oxidative Stress; D012720:Severity of Illness Index; D018754:Ventricular Dysfunction / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000652:urine
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D001663:Bilirubin