Urinary biopyrrins levels are elevated in relation to severity of heart failure.
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.
Hokamaki
Jun
J
Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan.
Kawano
Hiroaki
H
Yoshimura
Michihiro
M
Soejima
Hirofumi
H
Miyamoto
Shinzo
S
Kajiwara
Ichiro
I
Kojima
Sunao
S
Sakamoto
Tomohiro
T
Sugiyama
Seigo
S
Hirai
Nobutaka
N
Shimomura
Hideki
H
Nagayoshi
Yasuhiro
Y
Tsujita
Kenichi
K
Shioji
Izuru
I
Sasaki
Shinya
S
Ogawa
Hisao
H
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
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D001663:Bilirubin