Transient enhancement of oxidant stress and collagen turnover in patients with acute worsening of congestive heart failure.
BACKGROUND
Myocardial remodeling is a crucial step for progression of heart failure (HF). Free radical generation by the failing myocardium has been proposed as linked to myocardial remodeling. The aim of this study was to evaluate the urinary excretion of 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha), a reliable marker for oxidant stress in vivo, and collagen turnover in patients with acute worsening of congestive HF.


RESULTS
Enrolled were 43 patients with acute worsening of congestive HF of various etiologies. On admission (acute phase) and after approximately 2 weeks of conventional treatment (chronic phase), the following were measured: (1) immunoreactive urinary 8-iso-PGF2alpha, (2) serum total antioxidant status (TAS); and (3) serum levels of procollagen type I carboxyterminal peptide (PIP) and carboxyterminal collagen type I telopeptide (CITP), biochemical markers for collagen synthesis and degradation, respectively. From the acute to the chronic phase the parameters changed as follows: 335.1+/-245.4 to 205.3+/-107.4 pg/mg creatinine for urinary 8-iso-PGF2alpha (p<0.0001); 0.92+/-0.16 to 0.98+/-0.13 mmol/L for TAS (p<0.01); 171.4+/-72.5 to 93.7+/-33.9 ng/ml for PIP (p<0.0001); and 7.2+/-3.6 to 12.6+/-8.4 ng/ml for CITP (p<0.0001).


CONCLUSIONS
Acute worsening of congestive HF promotes free radical generation and collagen synthesis.
Department of Cardiology, Higashi-osaka City General Hospital, Osaka, Japan.
Megumi
M
Kunishige
Yoshiyuki
Y
Kijima
Taku
T
Sakai
Osamu
O
Akutagawa
Akiko
A
Matsuo
Akira
A
Nishibe
Yusuke
Y
Nakagawa
Takeshi
T
Hata
D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D003094:Collagen / Q000378:metabolism*; D024042:Collagen Type I / Q000097:blood; D015237:Dinoprost / Q000031:analogs & derivatives / Q000652:urine; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000378:metabolism* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009638:Norepinephrine / Q000097:blood; D018384:Oxidative Stress / Q000502:physiology*; D010446:Peptide Fragments / Q000378:metabolism; D012720:Severity of Illness Index
D024042:Collagen Type I; D010446:Peptide Fragments; D020097:Natriuretic Peptide, Brain; C075750:8-epi-prostaglandin F2alpha; D003094:Collagen; D002097:C-Reactive Protein; D015237:Dinoprost; D009638:Norepinephrine