Assessment of neurohumoral regulation and oxidative stress indices in patients with postinfarction cardiosclerosis

Amaç: Kronik kalp yetmezlikli hastalarda oksidatif stres ve natriüretik peptid seviyelerini değerlendirmeyi amaçladık Metodlar: Kalp yetmezliği ile komplike olmuş postinfarktüs kardiosklerozlu 52 erkek hastada(yaş:38-60), NP-NT-pro BNP, malondialdehid-benzeri aktivite (MDA), enzimler-katalaz ve superoksit dismutaz (SOD), NO metabolitleri (NO2-NO3), NADPH-diaforaz(eNOS), nitrat redtiktaz(INOS) ve peroksinitrat (ONOO) ın kan plazma seviyeleri ölçüldü ve 6 dakika yürüme testi uygulandı. Sonuçlar: Kontrol grubu ile kıyaslandığmda NYHA sınıf 2-3 hastalarda sırasıyla bazal NT-proBNP seviyelerinin 2,4 ve 3,4 kat, MDA seviyelerinin 2,5 ve 3,5 kat, ONOO formunun 2 ve 3,1 kat, SOD indeksinin %35 ve %44,7 oranında arttığı saptandı. NYHA sınıf 2-3 de kontrol grubu ile kıyasla sırasıyla eNOS %24,6 ve %42,6, NO metabolitleri %28,6 ve %45,4, katalaz seviyesi %37 ve %46,3 arttığı görüldü. Tartışma: NT-proBNP seviyelerinin NYHA sınıfı ve oksidatif stresin ciddiyeti ile ilişkili olduğu gösterilmiştir. Farklı NYHA sımflarına bağlı olarak natriüretik peptid seviyesinin ve oksidatif stres ürünlerinin ki bvınlar artmış MDA ürünleri ve azalmış antioksidan enzimler ve NO metabolitleri olup, bunların artmış olduğunu saptadık.

Postinfarktüs kardiyosklerozlu hastalarda oksidatif stres parametreleri ve nörohumoral regülasyonun değerlendirilmesi

Purpose: The purpose of this study was to assess the indices of natriuretic peptide and oxidative stress in patients with CHF. Methods: In 52 patients, men (age: 38-60) with postinfarction cardiosclerosis, complicated by chronic heart failure, we determined levels of NP – NT-pro BNP, malondialdehyde – like activity (MDA), enzymes – catalase and superoxide dismutase (SOD), NO metabolites (NO2 – NO3), NADPHdiaphorase (eNOS), Nitrate reductase (iNOS) and Peroxinitrate (ONOO-) in blood plasma of all patients and performed six-minute walk test. Results: Baseline NT-pro BNP was elevated by 2,4 and 3,4 times, MDA level by 2,5 and 3,5 times, formation of ONOO- by 2 and 3,1 times, SOD index by 35 and 44,7% in NYHA II – III Classes, respectively, compared to the control group. eNOS was decreased by 24,6 and 42,6%, NO metabolites by 28,6 and 45,4%, catalase level by 37 and 46,3% in NYHA II – III Classes, respectively, compared to the control group. Conclusion: The analysis of NT-pro BNP level has demonstrated its correlation with the NYHA Classes and the severity of oxidative stress. Along with different NYHA Classes, we noted increasing level of natriuretic peptide and enhancing oxidative stress processes, characterized by elevated MDA indices and decreased antioxidant enzymes and NO metabolites.

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