RESUMO
BACKGROUND: In addition to the genetic complexity of hypertrophic cardiomyopathy (HCM), there must be other disease-modifying factors that contribute to its highly variable clinical and phenotypic expression. The authors aimed to investigate serum thiol/disulphide homeostasis as a proxy for oxidative stress using a novel automated assay in patients with HCM. METHODS: This cross-sectional study was conducted on 119 patients with HCM and 52 without HCM. The methods used to measure dynamic thiol/disulphide homeostasis as calorimetric and duplex quantities were developed in 2014. RESULTS: Median serum native thiol levels were significantly lower in patients with HCM than in those without (312.5⯵mol/L [285-370⯵mol/L] vs 421⯵mol/L [349-469.5⯵mol/L]; pâ¯< 0.001). Serum total thiol levels and disulphide levels were considerably lower than those in the control group ([844.68⯱ 195.99⯵mol/L vs 1158.92⯱ 243.97⯵mol/L; pâ¯< 0.001], [259.13⯱ 65.66⯵mol/L vs 375.02⯱ 79.99⯵mol/L; pâ¯< 0.001], respectively). Serum disulphide/native thiol ratios and disulphide/total thiol ratios were significantly lower in HCM patients than in controls (0.80⯱ 0.09 vs 0.92⯱ 0.05; pâ¯< 0.001 and 0.31 [0.30-0.32] vs 0.32 [0.32-0.33]; pâ¯< 0.001). Finally, reduced thiol ratios were higher and oxidized thiol ratios were significantly lower in patients with HCM than in controls. CONCLUSIONS: Despite the fact that antioxidant capacity was impaired, the extracellular environment remained in a reducing state by keeping serum disulphide/native thiol ratios low. Therefore, the authors speculate that HCM may behave similarly to tumours with respect to serum thiol-disulphide levels.