Document Detail


Exercise-induced increases in oxidized low-density lipoprotein are associated with adverse outcomes in chronic heart failure.
MedLine Citation:
PMID:  17996825     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Oxidative stress is an important pathophysiologic feature in chronic heart failure (CHF) and may in part result from the inability to counteract acute surges of circulating oxidant products. Oxidized low-density lipoprotein (oxLDL) is an emerging prognostic marker in CHF. Accordingly, we investigated the effect of exercise-induced oxidative stress on circulating levels of oxLDL and its association with clinical outcomes in CHF. METHODS AND RESULTS: Plasma levels of oxLDL and low-density lipoprotein cholesterol (LDL-c) were measured at rest and after maximal exercise in 48 subjects with CHF and 12 healthy controls. Subjects with CHF had a higher baseline oxLDL (77.7 +/- 3.2 U/L vs 57.9 +/- 5.0 U/L, P = .01) and a higher baseline oxLDL/LDL-c ratio (0.87 +/- 0.04 vs 0.49 +/- 0.04, P < or = .001). Exercise induced an increase in oxLDL in subjects with CHF (77.7 +/- 3.2 U/L to 85.3 +/- 3.0 U/L, P < or = .001) but not in controls (57.9 +/- 5.0 to 61.4 +/- 5.5, P = .17). In 39 subjects for whom follow-up data were available, an increase in oxLDL of more than 11.0 U/L was associated with an increased risk to meet a combined end point of death and need for ventricular assist device or heart transplant during a 19-month follow-up period (hazard ratio 8.6; 95% confidence interval 1.0-73.8, P = .05); this remained significant when adjusted for peak oxygen consumption, left ventricular ejection fraction, New York Heart Association class, sex, and age (hazard ratio 46.6, 95% confidence interval 1.5-1438.1, P = .02). CONCLUSION: Plasma oxLDL and the oxLDL/LDL-c ratio are elevated in subjects with CHF. Whether assessment of oxLDL during maximal exercise allows early identification of subjects at highest risk for adverse outcomes should be systematically investigated.
Authors:
Ulrich P Jorde; Paolo C Colombo; Kartikya Ahuja; Alhakam Hudaihed; Duygu Onat; Thomas Diaz; David S Hirsh; Edward A Fisher; Chi-Hong Tseng; Timothy J Vittorio
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  13     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-12     Completed Date:  2008-02-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  759-64     Citation Subset:  IM    
Affiliation:
Division of Cardiology, New York Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biological Markers
Case-Control Studies
Cholesterol, LDL / blood*
Exercise / physiology*
Female
Free Radicals
Heart Failure / drug therapy*,  physiopathology,  therapy
Humans
Lipid Peroxidation
Male
Middle Aged
Oxidative Stress*
Oxygen Consumption
Prognosis
Prospective Studies
Stroke Volume
Treatment Outcome*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cholesterol, LDL; 0/Free Radicals

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