Indicators of antioxidant defense, oxidant system and systemic inflammatory response in patients with chronic systolic heart failure, depending on the main clinical and instrumental characteristics

July 5, 2018
793
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Objective — to study the activity of oxidative stress, antioxidant enzymes and immune response in patients with systolic chronic heart failure (CHF), depending on their basic clinical characteristics. Materials and me­thods. 149 patients with systolic CHF due to ischemic heart disease and/or arterial hypertension, as well as dilatational cardiomyopathy II–IV NYHA classes were examined. The control group consisted of 20 practically healthy persons of comparable age. Results. When comparing patients with CHF and healthy controls almost all of the differences were statistically significant. When comparing groups according to the stage, in patients with CHF IIB–III stage significantly higher level of plasma citrulline, a lower level of reserve capacity of the monocytes and lymphocytes were observed. Comparing groups of median weekly average furosemide doses in patients with ≥280 mg, the levels of uric acid and malondialdehyde were significantly higher, along with a decrease in the level of lymphocytes. When comparing groups according to the degree of left ventricular dilatation in patients with end diastolic size >6.8 cm a significant decrease in the level of superoxide dismutase and increase in the level of citrulline plasma were found. In group of patients with atrial fibrillation, diene conjugates, malondialdehyde and products of free radical oxidation of proteins were significantly higher. Conclusions. Patients with CHF and left ventricular ejection fraction <45% are characterized by lower activity of antioxidant enzymes, higher levels of free radical oxidation of lipids and proteins and uric acid. In patients with CHF, tumor necrosis factor-α, interleukin-6 and plasma citrulline levels are significantly higher, along with lower levels of blood lymphocytes.

L.G. Voronkov, N.G. Lipkan, T.I. Gavrylenko, L.S. Mkhitaryan

Key words: chronic heart failure, oxidative stress, immune activation, citrulline.

Published: 05.07.2018

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