摘要
背景:先前的研究结果支持氧自由基在充血性心力衰竭(CHF)的发生中具有一定作用。本研究旨在探讨接受现代药物治疗的CHF患者中脂质过氧化作用是否增强,脂质过氧化标记物的血浆水平与心力衰竭(HF)严重程度之间是否呈正相关。血浆丙二醛(MDA)和异前列烷通常被作为脂质过氧化和氧化应激的标记物。
Background: Previous studies support a role of oxygen-free radicals in the development of congestive heart failure(CHF). The aim of this study was to investigate whether lipid peroxidation is increased in CHF patients on modern pharmacological therapy and whether there is a positive correlation between plasma levels of markers of lipid peroxidation and severity of heart failure(HF). Plasma malondialdehyde(MDA) and isoprostanes are often used as markers of lipid peroxidation and oxidative stress. We also studied whether long-term treatment with isosorbide-5-mononitrate(IS-5-MN) in combination with standard HF therapy affects P-MDA levels in patients with evidence of left ventricular(LV) dysfunction following acute myocardial infarction(AMI). Materials and methods: Ninety-two patients with clinical or echocardiographic evidence of LV-dysfunction following AMI were randomized to treatment with either IS-5-MN or placebo. In a subgroup of 83 patients with available plasma MDA, echocardiography, right-heart catherization, and plasma natriuretic peptides were evaluated. Control subjects were 80 healthy blood donors. A second study group consisted of 56 patients with CHF, evaluated with respect to LV function, brain natriuretic peptide and markers of oxidative stress(P-MDA and 8-isoprostane). The second control group comprised 50 healthy subjects. Results: Lipid peroxidation measured by P-MDA and 8-isoprostane was not increased in patients with LV dysfunction treated with standard HF therapy. No positive correlation was found to the severity of HF. Long-term IS-5-MN therapy did not influence P-MDA concentrations. Conclusions: Although results from many experimental and clinical studies suggest that oxidative stress is increased in HF, this may not be true for patients treated with beta blockers and inhibitors of the renin-angiotensin system.
