Vascular function and the role of oxidative stress in heart failure, heart transplant, and beyond.
Vascular function and the role of oxidative stress in heart failure, heart transplant, and beyond.
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DOI：
10.1161/hypertensionaha.112.193318
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Richardson RS
中科院分区：
文献类型：
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作者：
Witman MA;Fjeldstad AS;McDaniel J;Ives SJ;Zhao J;Barrett-O'Keefe Z;Nativi JN;Stehlik J;Wray DW;Richardson RS
通过血流介导的血管舒张（FMD）、反应性充血（RH）和急性口服抗氧化剂鸡尾酒（AOC[维生素C、E和α-硫辛酸]），本研究旨在更深入地了解射血分数降低（HFrEF）和心脏移植（HTx）后几个时间点慢性心力衰竭患者血管功能的改变和氧化应激的作用。共有61名年龄匹配的受试者（12名健康对照，14名NYHA II类和III类HFrEF患者，以及35名HTx接受者（HTx治疗后< 3年，HTx治疗后5-10年，HTx治疗后14年））在肱动脉FMD和RH检测前服用安慰剂（PL）或AOC。FMD测量的血管功能在对照组（6.8±1.9%）、htx术后< 3年组（8.1±1.2%）和htx术后5-10年组（5.5±1.0%）之间无显著差异。然而，HFrEF患者的PL FMD较低（4.5±0.7%），htx后14年>组较低（2.9±0.8%）。AOC增加了各组血浆抗坏血酸水平，但仅在对照组（PL 6.8±1.9%;AOC 9.2±1.0%）和14年后接受htx治疗的>组（PL 2.9±0.8%;AOC 4.5±1.3%）中增加了FMD。在PL组和AOC组中RH均无差异。这项横断面研究显示，与对照组相比，HFrEF患者的血管功能变迟钝，HTx后不久与之相似，但HTx后随着时间的延长而下降，自由基参与了这一进展。
Using flow-mediated vasodilation (FMD), reactive hyperemia (RH), and an acute oral antioxidant cocktail (AOC [Vitamin C, E and α-lipoic acid]), this study aimed to provide greater insight into altered vascular function and the role of oxidative stress in chronic heart failure patients with reduced ejection fraction (HFrEF) and at several time points beyond heart transplantation (HTx). A total of 61 age-matched subjects (12 healthy controls, 14 NYHA Class II and III HFrEF patients, and 35 HTx recipients (< 3 yrs post-HTx, 5-10 yrs post-HTx, and > 14 yrs post-HTx)) ingested either placebo (PL) or an AOC prior to FMD and RH testing of the brachial artery. Vascular function, as measured by FMD, was not different between the controls (6.8 ± 1.9 %), recent < 3 yrs post-HTx group (8.1 ± 1.2%), and the 5-10 yrs post-HTx group (5.5 ± 1.0%). However, PL FMD was lower in the HFrEF patients (4.5 ± 0.7%) and in the > 14 yrs post-HTx group (2.9 ± 0.8%). The AOC increased plasma ascorbate levels in all groups, but only increased FMD in the controls (PL 6.8 ± 1.9%; AOC 9.2 ± 1.0%) and > 14 yrs post-HTx recipients (PL 2.9 ± 0.8%; AOC 4.5 ± 1.3%). There were no differences in RH in any of the groups with PL or AOC. This cross-sectional study reveals that, compared to controls, vascular function is blunted in HFrEF patients, is similar soon after HTx, but is decreased with greater time post-HTx with free radicals implicated in this progression.