Uncontrolled dyslipidemia and oxidative stress in chronic heart failure

Introduction: Although the notion of oxidative stress (OS) and its role in chronic heart failure (CHF) have been extensively studied in recent decades, a targeted analysis of the production of highly reactive oxygen species (hROS) in CHF was not possible. Studies show a link between uncontrolled dyslipidemia and the level of SO in CHF, but data on the relationship between lipid profile and (hROS) production (recognized for cellular toxic potential) are missing.

Objective: The objective of the study is to analyze the production of hROS – peroxynitrite, hydroxyl radical and hypochlorite anion – in platelets collected from patients with cCHF, in relation to the lipid profile, using novel fluorescent probes, capable of detecting hROS with high specificity and sensitivity.

Methods: We included 61 patients with CHF, 49% men, mean age 74 years, of whom 24 in NYHA functional class I-II (Group 1) and 37 patients in NYHA functional class III-IV (Group 2). The detection of hROS was performed by the simultaneous use of two fluorescent samples, aminophenyl fluorescein (APF) and hydroxyphenyl fluorescein (HPF), spectrofluorimetrically measuring the fluorescent emission of isolated platelets previously incubated with these fluorescent samples. Both APF and HPF detect peroxynitrite and hydroxyl, while APF additionally detects the hypochlorite anion. The lipid profile was assessed by determining total cholesterol (ChT), LDL-Ch and triglycerides (TG). The fluorescence of APF and HFP was correlated with lipid parameters in the two groups of patients.

Results: 21 (34%) patients had type 2 diabetes, 28 (46%) dyslipidemia, 21 (34%) were smokers, 37 (61%) overweight, and 33 patients (54%) were on lipid-lowering treatment with statins. Target lipid values under treatment were reached in 8 (13%) patients, the mean LDL-Ch in the study group being 91.7 ± 41 mg/dl, 82 ± 42 mg/dl in Group 1 and 101.3 ± 40.7 mg/dl in Group 2. The mean value of triglycerides in the study group was 104 ± 64 mg/dl, in Group 1 121.5 ± 69.5 mg/dl and ± 59.7 mg/dl in Group 2. APF fluorescence associated with ChT (r = 0.3, p = 0.009) and LDL-Ch choles-terol (r = 0.28, p = 0.029) in Group 1, and with TG (r = 402, p = 0.014) in Group 2. 49% of the variability of APF fluorescence in Group 2 was due to high triglyce-ride levels. HFP fluorescence did not correlate with lipid parameters.

Conclusions: In patients with chronic heart failure, therapeutically uncontrolled dyslipidemia is associated with an increase in highly reactive oxygen species, with an increase in the hypochlorite anion. In patients in class III-IV NYHA, therapeutically uncontrolled hypertriglyceridemia is an important predictor of in-creased production of highly reactive oxygen species.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)