Relationship between oxidative stress and systolic dysfunction in patients with hypertrophic cardiomyopathy.
BACKGROUND
Progression of hypertrophic cardiomyopathy (HCM) to left ventricular dilatation and systolic dysfunction sometimes occurs. However, the mechanism is not known. We examined whether oxidative stress was elevated in myocardia of HCM patients and whether the levels were correlated with left ventricular dilatation and systolic dysfunction.


RESULTS
Endomyocardial biopsy samples obtained from the right ventricular side of the septum of 31 patients with HCM, and 10 control subjects were studied immunohistochemically for the expression of 4-hydroxy-2-nonenal (HNE)-modified protein, which is a major lipid peroxidation product. Expression of HNE-modified protein was found in all myocardial biopsy samples from patients with HCM. Expression was distinct in the cytosol of cardiomyocytes. The expression levels in patients with HCM were significantly increased compared with those in control subjects (P = .0005). The expression levels in patients with HCM were correlated with left ventricular end-diastolic diameter (r = 0.483, P = .0053) and end-systolic diameter (r = 0.500, P = .0037) determined by echocardiography. The expression levels were inversely correlated with left ventricular ejection fraction determined by left ventriculography (r = -0.640, P = .0001).


CONCLUSIONS
Oxidative stress was elevated in myocardia of HCM patients and the levels were correlated with left ventricular dilatation and systolic dysfunction. Oxidative stress is involved in the pathogenesis of heart failure in patients with HCM.
Nakamura
Kazufumi
K
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
Kusano
Kengo Fukushima
KF
Matsubara
Hiromi
H
Nakamura
Yoichi
Y
Miura
Aya
A
Nishii
Nobuhiro
N
Banba
Kimikazu
K
Nagase
Satoshi
S
Miyaji
Katsumasa
K
Morita
Hiroshi
H
Saito
Hironori
H
Emori
Tetsuro
T
Ohe
Tohru
T
D000447:Aldehydes / Q000378:metabolism; D001706:Biopsy; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D007150:Immunohistochemistry; D015227:Lipid Peroxidation; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D018384:Oxidative Stress; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000503:physiopathology
D000447:Aldehydes; C027576:4-hydroxy-2-nonenal