Abstract 17142: Clinical Significance of Reactive Oxygen Metabolites in Heart Failure (HF) With Reduced Left Ventricular Ejection Fraction (HFrEF) Patients

    loading  Checking for direct PDF access through Ovid

Abstract

Background: Derivative of reactive oxygen metabolites (DROM), reflecting blood hydroperoxide levels, is a new marker of reactive oxygen species (ROS). We investigated the role of DROM in HFrEF.

Methods: We measured DROM in consecutive 204 HFrEF patients at the stable condition, and followed them until the occurrence of cardiovascular events (CVE). In a subgroup analysis, DROM levels were also measured at the aortic root and coronary sinus in 49 patients.

Results: DROM values were significantly higher in HFrEF patients (n=112) compared to risk-matched non-HF patients (n=112) (p=0.04). Moreover, DROM was associated with the severity of HF (p<0.01). DROM was independently associated with the severity of HF by multivariate logistic regression analysis (odds ratio 1.01, p<0.01). Furthermore, DROM values significantly correlated with other biomarkers (high-sensitivity C-reactive protein and B-type natriuretic peptide [BNP]), and echo-parameters in HFrEF (left ventricular ejection fraction [LVEF] and tricuspid regurgitation pressure gradient). In multivariate Cox-proportional-hazard analysis, DROM (hazard ratio: 1.01, 95% confidence interval: 1.00-1.02, p=0.03), BNP values (P=0.03), and the presence of ischemic heart disease (P=0.01) were independently associated with CVE in HFrEF. Kaplan-Meier analysis demonstrated significant higher probabilities of CVE in high-DROM group (>351 U.CARR; median value of DROM) than in low-DROM group (<351 U.CARR) in HFrEF (log-rank test, P<0.01). After HFrEF patients were divided into 4 groups according to a combination of DROM and BNP values, high-DROM and high-BNP group had a highest probability of CVE among 4 groups (log-rank test, p<0.001) Additionally, the transcardiac gradient of DROM values was significantly higher in HFrEF than in non-HF patients (p=0.04), indicating an association between DROM production in the coronary circulation and HFrEF development. Moreover, changes in DROM following optimal therapy were significantly associated with LVEF improvement in HFrEF patients (p=0.04).

Conclusion: The higher levels of DROM in HFrEF patients and their association with future CVE suggest the clinical benefit of DROM measurements in the risk stratification of HFrEF.

Related Topics

    loading  Loading Related Articles