Plasma adrenolutin as a marker of increased oxidative stress in children with severe chronic heart failure

ABSTRACT

The objective of this study was to measure the plasma levels of a marker of oxidative stress [adrenolutin, the oxidative product of catecholamines] and oxidative defenses [antioxidants; vitamin E and C] in children with chronic congestive heart failure [CHF], and to determine the prognostic value of adrenolutin in these patients, A total of 45 children with chronic CHF [>/= 6 months], with a mean age of 6.0 +/- 2.4 years, were enrolled in the study. They included Ross class II [13 patients], class III [15 patients], and class IV [17 patients]. Twenty healthy children served as a control group. Clinical and echocardiographic assessment was performed for every patient. Plasma adrenolutin, norepinephrine, and epinephrine levels were measured using high-performance liquid chromatography [HPLC], and plasma vitamin E and C levels were assayed. The relation of plasma adrenolutin levels to prognosis was evaluated at follow up period of 6 months. The results showed significantly higher plasma adrenolutin and catecholamine levels in children with chronic CHF as compared to controls, and increased with the severity of the disease with the highest levels in Ross class III and IV patients [P<0.05]. Plasma adrenolutin levels were significantly higher in children with poor prognosis or death during follow-up [P<0.01]. Plasma antioxidant levels [Vitamin C and E] significantly decreased with the severity of chronic CHF and When compared to controls [P<0.05]. There was a significant negative correlation between plasma adrenolutin and vitamin C levels [P<0.05]. Plasma adrenolutin is significantly increased in children with severe chronic CHF, as a marker of increased oxidative stress, and it is associated with a poor prognosis or death; whereas plasma antioxidants [Vitamin C and E] significantly decrease with increasing severity of chronic heart failure. Antioxidant supplements maybe of therapeutic benefit in patients with chronic CHF