Increased F2 isoprostane plasma levels in patients with congestive heart failure are correlated with antioxidant status and disease severity

Abstract Objectives Gastrointestinal symptoms are prevalent extracardiac systemic manifestations of Congestive Heart Failure (CHF). We developed a comprehensive panel of methods to unravel gut dysfunction in CHF and its impact on the anabolic response to feeding. Methods We recruited 14 clinically stable CHF patients (ejection fraction: 33.9 ± 2.1, NYHA class: 2.3 ± 0.2) and 17 healthy controls matched for age and gender. Stable tracers of L-phenylalanine (PHE)-[ring-2H5] and L-tyrosine (TYR)-[13C9,15 N] were administered intravenously for 5 hours via primed constant and continuous infusion. After 2 hours, participants ingested a complete high protein meal containing L-PHE-[1–13C] and spirulina-[U-15 N]. We sampled blood throughout the study to analyze enrichments by LC-MS/MS. We calculated the anabolic response to feeding before and after correction for changes in protein digestion and absorption, assessed by spirulina degradation ratio (L-PHE-[15 N]/[1–13C]). Moreover, we measured small intestinal membrane integrity and active carrier-mediated glucose transport by urinary recovery of the orally ingested inert sugars lactulose, rhamnose, and 3-O-methyl-glucose. Disease severity was assessed by medical chart and history. Statistical analysis was performed by unpaired t-tests. Data are expressed as mean ± SEM. Results In CHF patients, protein digestion and absorption were reduced (0.66 ± 0.04 vs. 0.82 ± 0.04, P < 0.01), which further attenuated the anabolic response to feeding (28.3 ± 3.8 vs. 54.0 ±5.5 μmol/kg FFM/meal, P < 0.001). Disturbances in protein digestion and absorption as well as anabolic response in CHF were independent of disease severity. Small intestinal permeability and active carrier-mediated glucose transport did not differ between the groups indicating a preserved enterocyte function in CHF patients. Conclusions We hypothesize that enhancing protein digestion and absorption in patients with CHF can improve the availability of nutrients and protein anabolism. Funding Sources National Institutes of Health

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Relationships between plasma levels of catecholamines and neuropeptides and the survival time in patients with congestive heart failure

Journal of Internal Medicine ◽

10.1111/j.1365-2796.1994.tb01267.x ◽

1994 ◽

Vol 235 (6) ◽

pp. 595-601 ◽

Cited By ~ 12

Author(s):

S. VALDEMARSSON ◽

A. BERGDAHL ◽

L. EDVINSSON

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Survival Time ◽

Plasma Levels

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571 Cardiac troponin T in patients with congestive heart failure: correlations with clinical measures of disease severity

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(04)90430-4 ◽

2004 ◽

Vol 3 (1) ◽

pp. 149-150

Author(s):

C STOSIC

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Disease Severity ◽

Cardiac Troponin ◽

Troponin T ◽

Cardiac Troponin T ◽

Clinical Measures

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Theophylline Toxicity—A Consequence of Congestive Heart Failure

Drug Intelligence & Clinical Pharmacy ◽

10.1177/106002808301700119 ◽

1983 ◽

Vol 17 (1) ◽

pp. 59-60 ◽

Cited By ~ 5

Author(s):

Donald F. LeGatt

Keyword(s):

Heart Failure ◽

Elderly Patient ◽

Congestive Heart Failure ◽

Plasma Levels ◽

Plasma Concentrations ◽

Great Variability ◽

Careful Monitoring ◽

A Value ◽

Oral Doses

A case is reported of an elderly patient with congestive heart failure (CHF), who was treated with juvenile oral doses of theophylline (Theo-Dur). The patient experienced toxic symptoms, and plasma concentrations were determined. A value of 60.6 μg/ml was reported and the theophylline administration was subsequently discontinued. Plasma concentrations and toxicity of theophylline are unpredictable in patients with CHF because of the great variability in clearance. This case demonstrates the necessity for careful monitoring of theophylline plasma levels in CHF patients.

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Human atrial natriuretic factor in patients with congestive heart failure. Plasma levels, hemodynamic, hormonal and renal changes after intravenous administration

Acta Endocrinologica ◽

10.1530/acta.0.111s166 ◽

1986 ◽

Vol 113 (1_Suppl) ◽

pp. S166 ◽

Cited By ~ 1

Author(s):

A.J.G. RIEGGER ◽

E.P. KROMER ◽

K. KOCKSIEK

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Intravenous Administration ◽

Plasma Levels ◽

Atrial Natriuretic Factor ◽

Natriuretic Factor ◽

Renal Changes ◽

Atrial Natriuretic

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Increased systemic inflammation and oxidative stress in patients with worsening congestive heart failure: improvement after short-term inotropic support

Clinical Science ◽

10.1042/cs20050317 ◽

2006 ◽

Vol 110 (4) ◽

pp. 483-489 ◽

Cited By ~ 69

Author(s):

Michel White ◽

Anique Ducharme ◽

Reda Ibrahim ◽

Lucette Whittom ◽

Joel Lavoie ◽

...

Keyword(s):

Oxidative Stress ◽

Heart Failure ◽

Congestive Heart Failure ◽

Systemic Inflammation ◽

Plasma Levels ◽

Inotropic Support ◽

Left Ventricular Ejection ◽

Short Term ◽

Hs Crp ◽

And Oxidative Stress

In the present study, we evaluated circulating pro-inflammatory mediators and markers of oxidative stress in patients with decompensated CHF (congestive heart failure) and assessed whether clinical recompensation by short-term inotropic therapy influences these parameters. Patients with worsening CHF (n=29, aged 61.9±2.7 years), NYHA (New York Heart Association) class III–IV, and left ventricular ejection fraction of 23.7±1.8% were studied. Controls comprised age-matched healthy volunteers (n=15; 54.1±3.2 years). Plasma levels of cytokines [IL (interleukin)-6 and IL-18], chemokines [MCP-1 (monocyte chemotactic protein-1)], adhesion molecules [sICAM (soluble intercellular adhesion molecule), sE-selectin (soluble E-selectin)], systemic markers of oxidation [TBARS (thiobarbituric acid-reactive substances), 8-isoprostaglandin F2α and nitrotyrosine] and hs-CRP (high-sensitivity C-reactive protein) were measured by ELISA and colorimetric assays at admission and 30 days following 72-h milrinone (n=15) or dobutamine (n=14) infusion. Plasma IL-6, IL-18, sICAM, E-selectin, hs-CRP and oxidative markers were significantly higher in patients on admission before inotropic treatment compared with controls (P<0.05). Short-term inotropic support improved clinical status as assessed by NYHA classification and by the 6-min walk test and significantly decreased plasma levels of IL-6, IL-18, sICAM, hs-CRP and markers of oxidation (P<0.05) at 30 days. The effects of milrinone and dobutamine were similar. In conclusion, our results demonstrate that patients with decompensated CHF have marked systemic inflammation and increased production of oxygen free radicals. Short-term inotropic support improves functional status and reduces indices of inflammation and oxidative stress in patients with decompensated CHF.

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Plasma Levels of Adrenomedullin in Patients with Acute Myocardial Infarction

Clinical Science ◽

10.1042/cs0940135 ◽

1998 ◽

Vol 94 (2) ◽

pp. 135-139 ◽

Cited By ~ 20

Author(s):

Yuji Yoshitomi ◽

Toshio Nishikimi ◽

Shunichi Kojima ◽

Morio Kuramochi ◽

Shuichi Takishita ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Congestive Heart Failure ◽

Atrial Natriuretic Peptide ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Right Atrium ◽

Plasma Levels ◽

The Right

1. Adrenomedullin, a newly identified vasorelaxant peptide, participates in the regulation of the cardiovascular system. To investigate the pathophysiological significance of adrenomedullin in patients with acute myocardial infarction, we measured plasma levels of adrenomedullin. 2. Cardiac catheterization was performed on admission, after 1 day, and after 4 weeks in 36 patients with acute myocardial infarction. We measured plasma levels of adrenomedullin, atrial natriuretic peptide and brain natriuretic peptide in the right atrium, pulmonary artery and aorta. 3. Plasma levels of adrenomedullin in the right atrium (mean ± SEM) were significantly increased on admission (4.2 ± 2.6 h) in patients with acute myocardial infarction (10.6 ± 1.0 pmol/l) compared with controls (5.2 ± 0.3 pmol/l, P < 0.01). In addition, plasma levels of adrenomedullin were further elevated in patients with congestive heart failure (12.3 ± 1.4 pmol/l) compared with patients without congestive heart failure (7.8 ± 0.6 pmol/l, P < 0.01). In patients with congestive heart failure, plasma adrenomedullin on admission significantly correlated with atrial natriuretic peptide and brain natriuretic peptide. 4. These results suggest that plasma adrenomedullin increases in the early phase of acute myocardial infarction and that volume expansion may be one of the additional stimuli for the release of adrenomedullin in patients with acute myocardial infarction complicated by congestive heart failure.

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