scholarly journals Mitochondrial reactive oxygen species generation in blood cells is associated with disease severity and exercise intolerance in heart failure patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ryosuke Shirakawa ◽  
Takashi Yokota ◽  
Takayuki Nakajima ◽  
Shingo Takada ◽  
Miwako Yamane ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Functional Class ◽  
Exercise Intolerance ◽  
Ros Generation ◽  
Oxygen Species ◽  
Mitochondrial Reactive Oxygen Species ◽  
Class Iii ◽  
Nyha Functional Class ◽  
Systemic Oxidative Stress

Abstract Systemic oxidative stress plays a key role in the development of chronic heart failure (CHF). We tested the hypothesis that mitochondrial reactive oxygen species (ROS) generation in circulating peripheral blood mononuclear cells (PBMCs) contributes to CHF progression. A total of 31 patients who had a history of hospital admission due to worsening HF were enrolled and grouped as having either mild CHF defined as New York Heart Association (NYHA) functional class I-II or moderate-to-severe CHF defined as NYHA functional class III. ROS levels in PBMC mitochondria were significantly increased in CHF patients with NYHA functional class III compared to those with NYHA functional class I-II, accompanied by impaired mitochondrial respiratory capacity in PBMCs. ROS generation in PBMC mitochondria was positively correlated with urinary 8-hydroxydeoxyguanosine, a systemic oxidative stress marker, in CHF patients. Importantly, mitochondrial ROS generation in PBMCs was directly correlated with plasma levels of B-type natriuretic peptide, a biomarker for severity of HF, and inversely correlated with peak oxygen uptake, a parameter of exercise capacity, in CHF patients. The study showed that ROS generation in PBMC mitochondria was higher in patients with advanced CHF, and it was associated with disease severity and exercise intolerance in CHF patients.

scholarly journals Systemic oxidative stress is associated with lower aerobic capacity and impaired skeletal muscle energy metabolism in heart failure patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takashi Yokota ◽  
Shintaro Kinugawa ◽  
Kagami Hirabayashi ◽  
Mayumi Yamato ◽  
Shingo Takada ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Skeletal Muscle ◽  
Energy Metabolism ◽  
Aerobic Capacity ◽  
Plantar Flexion ◽  
Exercise Intolerance ◽  
Whole Body ◽  
Resonance Spectroscopy ◽  
Systemic Oxidative Stress

AbstractOxidative stress plays a role in the progression of chronic heart failure (CHF). We investigated whether systemic oxidative stress is linked to exercise intolerance and skeletal muscle abnormalities in patients with CHF. We recruited 30 males: 17 CHF patients, 13 healthy controls. All participants underwent blood testing, cardiopulmonary exercise testing, and magnetic resonance spectroscopy (MRS). The serum thiobarbituric acid reactive substances (TBARS; lipid peroxides) were significantly higher (5.1 ± 1.1 vs. 3.4 ± 0.7 μmol/L, p < 0.01) and the serum activities of superoxide dismutase (SOD), an antioxidant, were significantly lower (9.2 ± 7.1 vs. 29.4 ± 9.7 units/L, p < 0.01) in the CHF cohort versus the controls. The oxygen uptake (VO2) at both peak exercise and anaerobic threshold was significantly depressed in the CHF patients; the parameters of aerobic capacity were inversely correlated with serum TBARS and positively correlated with serum SOD activity. The phosphocreatine loss during plantar-flexion exercise and intramyocellular lipid content in the participants' leg muscle measured by 31phosphorus- and 1proton-MRS, respectively, were significantly elevated in the CHF patients, indicating abnormal intramuscular energy metabolism. Notably, the skeletal muscle abnormalities were related to the enhanced systemic oxidative stress. Our analyses revealed that systemic oxidative stress is related to lowered whole-body aerobic capacity and skeletal muscle dysfunction in CHF patients.

scholarly journals Increased Interleukin-11 Levels Are Correlated with Cardiac Events in Patients with Chronic Heart Failure

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Jing Ye ◽  
Zhen Wang ◽  
Di Ye ◽  
Yuan Wang ◽  
Menglong Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Plasma Concentrations ◽  
Heart Association ◽  
Functional Class ◽  
Control Group ◽  
Class Iii ◽  
Cardiac Events ◽  
Nyha Functional Class ◽  
Interleukin 11

Background. Interleukin-11 (IL-11) is an important inflammatory cytokine and has been demonstrated to participate in cardiovascular diseases. However, there have been no studies about the role of IL-11 in heart failure (HF). The present study is aimed at investigating whether IL-11 levels are associated with the cardiac prognosis in patients with HF. Methods. The plasma concentrations of IL-11 were measured in 240 patients with chronic HF (CHF) and 80 control subjects without signs of significant heart disease. In addition, we prospectively followed these CHF patients to endpoints of cardiac events. Results. Compared with the control group, the plasma IL-11 concentrations were significantly increased in the CHF patients and gradually increased in the New York Heart Association (NYHA) functional class II group, the NYHA functional class III group, and the NYHA functional class IV group. The receiver operating characteristic (ROC) curve revealed that the predictive role of IL-11 in HF is not as good as N-terminal B-type natriuretic peptide (BNP), although IL-11 has a certain value in predicting cardiac events. In addition, the CHF patients were divided into 3 groups according to the plasma IL-11 concentration category (low, T1; middle, T2; and high, T3). The multivariate Cox hazard analysis showed that the high plasma IL-11 concentrations were independently associated with the presence of cardiac events after adjustment for confounding factors. Furthermore, the CHF patients were divided into two groups based on the median plasma IL-11 concentrations. The Kaplan-Meier analysis revealed that the patients with high IL-11 concentrations had a higher risk of cardiac events compared with those with low IL-11 concentrations. Conclusions. Higher plasma IL-11 levels significantly increase the presence of cardiac events and suggest a poor outcome; although the diagnostic value of IL-11 in CHF is not as good as BNP, there is a certain value in predicting cardiac events in CHF.

scholarly journals Clinical Predictors Influencing the Length of Stay in Emergency Department Patients Presenting with Acute Heart Failure

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 434
Author(s):  
Pungkava Sricharoen ◽  
Phichayut Phinyo ◽  
Jayanton Patumanond ◽  
Dilok Piyayotai ◽  
Yuwares Sittichanbuncha ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Length Of Stay ◽  
Acute Heart Failure ◽  
Multivariable Analysis ◽  
Heart Association ◽  
Functional Class ◽  
Class Iii ◽  
Clinical Predictors ◽  
Nyha Functional Class

Background and objectives: Acute heart failure is a common problem encountered in the emergency department (ED). More than 80% of the patients with the condition subsequently require lengthy and repeated hospitalization. In a setting with limited in-patient capacity, the patient flow is often obstructed. Appropriate disposition decisions must be made by emergency physicians to deliver effective care and alleviate ED overcrowding. This study aimed to explore clinical predictors influencing the length of stay (LOS) in patients with acute heart failure who present to the ED. Materials and Methods: We conducted prognostic factor research with a retrospective cohort design. Medical records of patients with acute heart failure who presented to the ED of Ramathibodi Hospital from January to December 2015 were assessed for eligibility. Thirteen potential clinical predictors were selected as candidates for statistical modeling based on previous reports. Multivariable Poisson regression was used to estimate the difference in LOS between patients with and without potential predictors. Results: A total of 207 patients were included in the analysis. Most patients were male with a mean age of 74.2 ± 12.5 years. The median LOS was 54.6 h (Interquartile range 17.5, 149.3 h). From the multivariable analysis, four clinical characteristics were identified as independent predictors with an increase in LOS. These were patients with New York Heart Association (NYHA) functional class III/IV (+72.9 h, 95%Confidence interval (CI) 23.9, 121.8, p = 0.004), respiratory rate >24 per minute (+80.7 h, 95%CI 28.0, 133.3, p = 0.003), hemoglobin level <10 mg/dL (+60.4 h, 95%CI 8.6, 112.3, p = 0.022), and serum albumin <3.5 g/dL (+52.8 h, 95%CI 3.6, 102.0, p = 0.035). Conclusions: Poor NYHA functional class, tachypnea, anemia, and hypoalbuminemia are significant clinical predictors of patients with acute heart failure who required longer LOS.

scholarly journals Factors Affecting Mortality in Patients with Blood-Culture Negative Infective Endocarditis

2020 ◽  
Vol 29 (01) ◽  
pp. 012-018
Author(s):  
Lira Firiana ◽  
Bambang Budi Siswanto ◽  
Emir Yonas ◽  
Radityo Prakoso ◽  
Raymond Pranata
Keyword(s):  
Heart Failure ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Risk Stratification ◽  
Hospital Mortality ◽  
Kidney Function ◽  
Functional Class ◽  
Class Iii ◽  
Nyha Functional Class ◽  
Culture Negative

AbstractInfective endocarditis retains high morbidity and mortality rates despite recent advances in diagnostics, pharmacotherapy, and surgical intervention. Risk stratification in endocarditis patients, including blood-culture negative endocarditis, is crucial in deciding the optimal management strategy; however, the studies investigating risk stratification in these patients were lacking despite the difference with blood-culture positive endocarditis. The aim of this study is to identify risk factors associated with in-hospital mortality in blood-culture negative infective endocarditis patients. A retrospective cohort study was conducted at National Cardiovascular Center Harapan Kita, Jakarta in blood-culture negative infective endocarditis patients from 2013 to 2015. Patient characteristics, clinical parameters, echocardiographic parameters, and clinical complications were collected from medical records and hospital information systems. There were 146 patients that satisfy the inclusion and exclusion criteria out of 162 patients with blood-culture infective endocarditis. The in-hospital mortality rate was 13.5%. On bivariate analyses, factors that were related to in-hospital mortality include New York Heart Association (NYHA) class III and IV heart failure (p = 0.007), history of hypertension (p = 0.021), stroke during hospitalization (p < 0.001), the decline in renal function (p < 0.001), and surgery (p = 0.028). Variables that were independently associated with mortality upon multivariate analysis were heart failure NYHA functional class III and IV (OR 7.56, p = 0.011), worsening kidney function (OR 10.23, p < 0.001), and stroke during hospitalization (OR 8.92, p = 0.001). Presence of heart failure with NYHA functional class III and IV, worsening kidney function, and stroke during hospitalization were independently associated with in-hospital mortality in blood-culture infective endocarditis patients.

Medical Management Guided by Pulmonary Artery Pressures in NYHA Functional Class III Heart Failure Patients

2011 ◽  
Vol 17 (8) ◽  
pp. S93 ◽  
Author(s):  
Maria Rosa Costanzo ◽  
William T. Abraham ◽  
Philip B. Adamson ◽  
Pam A. Cowart ◽  
Kevin M. Corcoran ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Artery ◽  
Medical Management ◽  
Functional Class ◽  
Class Iii ◽  
Heart Failure Patients ◽  
Nyha Functional Class

scholarly journals Evaluation of a chronic fatigue in patients with moderate-to-severe chronic heart failure

Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 366 ◽  
Author(s):  
Lina Jasiukevičienė ◽  
Donatas Vasiliauskas ◽  
Aušra Kavoliūnienė ◽  
Jolanta Marcinkevičienė ◽  
Regina Grybauskienė ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Chronic Fatigue ◽  
Functional Class ◽  
Cortisol Concentration ◽  
Class Iii ◽  
Nyha Functional Class ◽  
Adrenal Axis ◽  
Hypothalamus Pituitary Adrenal Axis ◽  
Pituitary Adrenal Axis

The aim of the study. To evaluate the chronic fatigue and its relation to the function of hypothalamus-pituitary-adrenal axis in patients with New York Heart Association (NYHA) functional class III–IV chronic heart failure. Material and methods. A total of 170 patients with NYHA functional class III–IV chronic heart failure completed MFI-20L, DUFS, and DEFS questionnaires assessing chronic fatigue and underwent echocardiography. Blood cortisol concentration was assessed at 8:00 AM and 3:00 PM, and plasma N-terminal brain natriuretic pro-peptide (NT-proBNP) concentration was measured at 8:00 AM. Neurohumoral investigations were repeated before cardiopulmonary exercise test and after it. Results. The results of all questionnaires showed that 100% of patients with NYHA functional class III–IV heart failure complained of chronic fatigue. The level of overall fatigue was 54.5±31.5 points; physical fatigue – 56.8±24.6 points. Blood cortisol concentration at 8:00 AM was normal (410.1±175.1 mmol/L) in majority of patients. Decreased concentration was only in four patients (122.4±15.5 mmol/L); one of these patients underwent heart transplantation. In the afternoon, blood cortisol concentration was insufficiently decreased (355.6±160.3 mmol/L); reaction to a physical stress was attenuated (∆ 92.9 mmol/L). Plasma NTproBNP concentration was 2188.9±1852.2 pg/L; reaction to a physical stress was diminished (∆ 490.3 pg/L). Conclusion. All patients with NYHA class III–IV heart failure complained of daily chronic fatigue. Insufficiently decreased blood cortisol concentration in the afternoon showed that in the presence of chronic fatigue in long-term cardiovascular organic disease, disorder of a hypothalamus-pituitary-adrenal axis is involved.

scholarly journals Oxidative stress and heart failure

2011 ◽  
Vol 301 (6) ◽  
pp. H2181-H2190 ◽  
Author(s):  
Hiroyuki Tsutsui ◽  
Shintaro Kinugawa ◽  
Shouji Matsushima
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Skeletal Muscle ◽  
Contractile Function ◽  
Functional Decline ◽  
Exercise Intolerance ◽  
Ros Generation ◽  
Antioxidant Enzyme Activities ◽  
Matrix Remodeling ◽  
The Matrix

Oxidative stress, defined as an excess production of reactive oxygen species (ROS) relative to antioxidant defense, has been shown to play an important role in the pathophysiology of cardiac remodeling and heart failure (HF). It induces subtle changes in intracellular pathways, redox signaling, at lower levels, but causes cellular dysfunction and damage at higher levels. ROS are derived from several intracellular sources, including mitochondria, NAD(P)H oxidase, xanthine oxidase, and uncoupled nitric oxide synthase. The production of ROS is increased within the mitochondria from failing hearts, whereas normal antioxidant enzyme activities are preserved. Chronic increases in ROS production in the mitochondria lead to a catastrophic cycle of mitochondrial DNA (mtDNA) damage as well as functional decline, further ROS generation, and cellular injury. ROS directly impair contractile function by modifying proteins central to excitation-contraction coupling. Moreover, ROS activate a broad variety of hypertrophy signaling kinases and transcription factors and mediate apoptosis. They also stimulate cardiac fibroblast proliferation and activate the matrix metalloproteinases, leading to the extracellular matrix remodeling. These cellular events are involved in the development and progression of maladaptive myocardial remodeling and failure. Oxidative stress is also involved in the skeletal muscle dysfunction, which may be associated with exercise intolerance and insulin resistance in HF. Therefore, oxidative stress is involved in the pathophysiology of HF in the heart as well as in the skeletal muscle. A better understanding of these mechanisms may enable the development of novel and effective therapeutic strategies against HF.

Effective extension of the pacemaker to the CRT-P with simultaneous percutaneous recanalization of the obstructed left brachiocephalic vein

2021 ◽  
Vol 4 (57) ◽  
pp. 28-30
Author(s):  
Paulina Rabiej-Krzyś ◽  
Marcin Szczasny ◽  
Tomasz Chromiński ◽  
Milena Stachyra ◽  
Piotr Błaszczak
Keyword(s):  
Heart Failure ◽  
Functional Class ◽  
Brachiocephalic Vein ◽  
Class Iii ◽  
Left Brachiocephalic Vein ◽  
Nyha Functional Class ◽  
Percutaneous Recanalization

We present a case of a man with a previously implanted DDD pacemaker, NYHA functional class III heart failure and asymptomatic left brachiocephalic vein obstruction. The DDD pacemaker was extended to the system of resychronization CRT-P despite obstruction of the left brachiocephalic vein.

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