Markers of oxidative damage in chronic heart failure: role in disease progression.
BACKGROUND
We aimed to study the relationship between markers of oxidative lipid or protein damage and ventricular remodeling and the validity of 8-epi-prostaglandin F(2alpha) (8-epi-PGF(2alpha)) as an indicator of disease severity in patients with ischemic chronic heart failure (CHF).


METHODS
We enrolled four groups of 12 patients with varying CHF according to the New York Heart Association (NYHA) classification and 25 controls. Urinary 8-epi-PGF(2alpha) and plasma malondialdehyde and protein thiol (P-SH) groups were correlated with echocardiographic indices of remodeling. The reliability of isoprostanes was analyzed by a receiver operating characteristics (ROC) curve.


RESULTS
NYHA class III and IV patients exhibited elevated 8-epi-PGF(2alpha) levels, increased malondialdehyde concentrations and decreased P-SH groups when compared to controls and NYHA I and II patients. 8-Epi-PGF(2alpha) and P-SH groups correlated significantly with indices of remodeling. The ROC curve drawn for 8-epi-PGF(2alpha) allowed us to differentiate NYHA class III and IV patients from NYHA class I and II patients with a sensitivity of 95.8% and specificity of 95.8% (cut off 0.84 ng/mg creatinine; area under curve 0.99; P < 0.001).


CONCLUSIONS
Markers of oxidative damage are unlikely to play a significant role in early stages of CHF. However, they might become important in the course of CHF when their concentrations reach critical levels. Urinary 8-epi-PGF(2alpha) is a reliable indicator of symptomatic CHF.
University Hospital Bezanijska Kosa, Belgrade, Serbia.
Slavica
S
Radovanovic
Mirjana
M
Krotin
Dragan V
DV
Simic
Jasmina
J
Mimic-Oka
Ana
A
Savic-Radojevic
Marija
M
Pljesa-Ercegovac
Marija
M
Matic
Nebojsa
N
Ninkovic
Branislava
B
Ivanovic
Tatjana
T
Simic
D000368:Aged; D002908:Chronic Disease; D015237:Dinoprost / Q000031:analogs & derivatives / Q000652:urine; D018450:Disease Progression; D004452:Echocardiography / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D028421:Isoprostanes / Q000737:chemistry; D008055:Lipids / Q000737:chemistry; D008297:Male; D008315:Malondialdehyde / Q000097:blood / Q000737:chemistry; D008875:Middle Aged; D018384:Oxidative Stress; D020257:Ventricular Remodeling
D028421:Isoprostanes; D008055:Lipids; C075750:8-epi-prostaglandin F2alpha; D008315:Malondialdehyde; D015237:Dinoprost