title: Evaluation of Oxidative Stress Markers and Catecholamine Changes in Patients with Dilated Cardiomyopathy Before and After Cardiopulmonary Exercise Testing.
abstract: BACKGROUND
  The aim of this study was to evaluate oxidative stress markers (OSM) and catecholamine levels in patients with dilated cardiomyopathy (DCM) before and after cardiopulmonary exercise testing, and to investigate the association between changes in these markers and the New York Heart Association classification (NYHA) and left ventricular ejection fraction (LVEF) in these patients.
  
  
  METHODS
  We evaluated 74 patients with DCM and 80 control subjects without DCM. Patients were grouped according to NYHA stages I/II or III/IV. Eligible participants were considered to be those with LVEF values <45%. The OSM analysed included superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), and glutathione peroxidase (GPX). The catecholamines analysed included adrenaline, noradrenaline, and dopamine. Vitamin C was also evaluated. All values were obtained before and after cardiopulmonary exercise testing.
  
  
  RESULTS
  There was a significant increase in GR, adrenaline, and noradrenaline after testing in the DCM patients. A significant difference between controls and patients in CAT and evaluated catecholamines was observed after testing. A significant increase in GR, GPX, adrenaline, and noradrenaline for patients in NYHA I/ II, and in CAT, GR, adrenaline, noradrenaline, and dopamine for patients in NYHA III/IV, was found between the different times of observation. LVEF before testing showed a significant positive correlation with GPX, and a negative correlation with noradrenaline and adrenaline. After testing a significant negative correlation was found with SOD and GR.
  
  
  CONCLUSIONS
  The results of our study demonstrate the complexity of the neurohumoral mechanisms and physiological alterations in the failing heart in DCM patients. Further studies are needed, including other biomarkers and larger samples of patients, in order to improve our understanding of the aetiopathogenesis of DCM development and progression.
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Dejan
authors.initials: D
authors.lastname: Simeunovic
authors.forename: Petar M
authors.initials: PM
authors.lastname: Seferovic
authors.forename: Arsen D
authors.initials: AD
authors.lastname: Ristic
authors.forename: Dejan
authors.initials: D
authors.lastname: Nikolic
authors.forename: Dijana
authors.initials: D
authors.lastname: Risimic
authors.forename: Jelena
authors.initials: J
authors.lastname: Seferovic
authors.forename: Ruzica
authors.initials: R
authors.lastname: Maksimovic
authors.forename: Ivana
authors.initials: I
authors.lastname: Nedeljkovic
authors.forename: Radmila
authors.initials: R
authors.lastname: Karan
authors.forename: Milica
authors.initials: M
authors.lastname: Bajcetic
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000378:metabolism* / Q000503:physiopathology; D002374:Catalase / Q000378:metabolism; D002395:Catecholamines / Q000378:metabolism*; D005080:Exercise Test / Q000379:methods*; D005979:Glutathione Peroxidase / Q000378:metabolism; D005980:Glutathione Reductase / Q000378:metabolism; D006333:Heart Failure / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D013482:Superoxide Dismutase / Q000378:metabolism; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D002395:Catecholamines; D002374:Catalase; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase; D005980:Glutathione Reductase