부산대학교 도서관

Background: In this translational study we addressed the significance of markers of oxidative lipid or protein damage and antioxidant enzyme activities in the development of left ventricle remodeling in chronic heart failure (CHF) following myocardial infarction. We tried to establish a link between oxidative stress markers and the degree of chronic heart failure.Patients and methods: 120 consecutive patients with varying CHF according to New York Heart Association classification (NYHA) and 69 controls were enrolled in this study. Malondialdehyde (MDA), protein thiol (P-SH) and reactive carbonyl groups (RCD), together with glutathione peroxidase (GSHPx) and superoxide dismutase (SOD) activities were determined spectrophotometrically and/or by ELISA methods and correlated with echocardiographic indices of remodeling (LVEDD, LVESD, LVEDV and LVESV).Results: Patients with severe CHF (NYHA III/IV) exhibited elevated MDA and RCD levels and decreased P-SH groups when compared to asymptomatic patients (NYHA I/II) or controls. Oxidative stress in severe patients was associated with significant fall in plasma GSHPx activity. Regarding remodeling, the main effects, observed in severe disease, were significant correlations between RCD and remodeling indices.Conclusions: Gradual increase in lipid peroxidation an oxidative damage of proteins, together with the down-regulated antioxidant enzymes in severe disease, additionally increased the systemic oxidative stress. This finding plays an important role in the development of remodeling in chronic heart failure, which leads to the further deterioration of left ventricular structure.