The pattern of ventricular remodeling influences the level of oxidative stress in heart failure patients

Abstract

Oxidative stress (OS) is increased in chronic diseases, including cardiovascular (CV), but there are few data on its effects on the heart and vessels. The isoprostanes (IsoP) are bioactive compounds, with 8-iso-PGF 25α being the most representative in vivo marker of OS. They correlate with the severity of heart failure (HF), but because data regarding OS levels in different types of HF are scarce, our study was aimed to evaluate it by assessing the urinary levels of 8-iso-PGF 2 alpha; and its correlations with various biomarkers and parameters. Our prospective study included 53 consecutive patients with HF secondary to ischemic heart disease or dilative cardiomyopathy, divided according to the type of HF (acute, chronic decompensated or chronic compensated HF). The control group included 13 hypertensive patients, effectively treated. They underwent clinical, laboratory-serum NT-proBNP, creatinine, uric acid, lipids, C reactive protein (CRP) and urinary 8-iso-PGF 2 alpha; and echocardiographic assessment. HF patients, regardless the type of HF, had higher 8-iso-PGF 2α than controls (267.32pg/μmol vs. 19.82pg/μmol, p< 0.001). The IsoP level was directly correlated with ejection fraction (EF) (r=-0.31, p= 0.01) and NT-proBNP level (r= 0.29, p= 0.019). The relative wall thickness (RWT) was negatively correlated with IsoP (r=-0.55, p< 0.001). Also 8-iso-PGF 25 alpha; was higher by 213.59pg/μmol in the eccentric left ventricular (LV) hypertrophy subgroup comparing with the concentric subgroup (p= 0.014), and the subgroups with severe mitral regurgitation (MR) and moderate/ severe pulmonary hypertension (PAH) had the highest 8-iso-PGF 2 alpha; levels. Male sex, severe MR, moderate/severe PAH, high LV mass and low RWT values were predictive for high OS level in HF patients.Eccentric cardiac remodeling, MR severity and PAH severity are independent predictors of OS in HF patients.