Transient Enhancement of Oxidant Stress and Collagen Turnover in Patients With Acute Worsening of Congestive Heart Failure

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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 F_<2α> (8-iso-PGF_<2α>), a reliable marker for oxidant stress in vivo, and collagen turnover in patients with acute worsening of congestive HF. Methods and 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-PGF_<2α>, (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±107.4pg/mg creatinine for urinary 8-iso-PGF_<2α> (p<0.0001) ; 0.92±0.16 to 0.98±0.13mmol/L for TAS (p<0.01) ; 171.4±72.5 to 93.7±33.9ng/ml for PIP (p<0.0001) ; and 7.2±3.6 to 12.6±8.4ng/ml for CITP (p<0.0001). Conclusions Acute worsening of congestive HF promotes free radical generation and collagen synthesis.
社団法人日本循環器学会の論文
2007-11-20