INDEX of Oxidative Stress in Heart Failure: Reciprocal Influence on Multihormonal Deficiencies 

Presentation Number: SAT 524
Date of Presentation: April 1st, 2017

Antonio Mancini*1, Chantal Di Segni1, Carmine Bruno2, Giulio Olivieri1, Nunzia Ciferri2, Edoardo Vergani2, Alfredo Pontecorvi1, Andrea Silvestrini1, Elisabetta Meucci1, Angela Venuti2, Maria Anna Nicolazzi2, Raffaele Landolfi2 and Angela Maria Rita Favuzzi2
1Catholic University of the Sacred Heart, Rome, Italy, 2Catholic University of the Sacred Heart


It is well known that heart failure (HF) is associated with oxidative stress (OS). Reactive oxygen species in fact influence sarcolemmal and mitochondrial ione channels, which are responsible for cardiomyocyte excitability and are important in myocardial remodeling after a myocardial infarction. On the other hand, several deficiencies of anabolic hormones (including GH, DHEAS, Testosterone), are reported to be correlated with the severity and prognosis of HF; a low-T3 syndrome is also present. OS could represent an underlying mechanism causing worsening of myocardial function. 

 In order to evaluate the relationships between anabolic hormones and indexes of OS and the impact on HF, we have studied a group of 21 patients (18 males  3 females, age 49-73 ys) affected by HF (NYHA II-III; EF<40%),  evaluating metabolic parameters (glycemia, total and fractioned cholesterol, uric acid, triglycerides, proteins), hormonal parameters (IGF-1, DHEAS, Testosterone, freeT3, freeT4, TSH, NT-proBNPand total plasma antioxidant capacity (TAC). TAC was evaluated by a spectrophotometric method, using H2O2–metmyoglobin system, which, interacting with the chromogen ABTS induces the appearance of its radical forms with a latency phase (LAG) proportional to antioxidant content of the sample. Hormone were measured by electrochemiluminesce method. 

 The most prevalent hormonal deficiencies were those of IGF-1 (83%) and DHEAS (82%). The association of multiple hormonal deficiencies correlated with levels of NT-proBNP (no deficit, n=5, 882±483.1; one deficit, n=5, 787±307,4, two deficit, n=4, 4199.3±2167.7; three or four deficit, n=7, 7968,8±5123,9 pg/ml) LAG values were significantly elevated in patients with one or more deficit versus patients with normal hormone pattern (106±11,3 vs 66,7±6.7 sec), but while patients with single hormonal deficiency showed the greatest levels (123,3±6,7), suggesting a compensatory increase in antioxidant systems, no further increase was observed with the worsening of hormonal picture (two deficit, 106,7±31; three or four deficit 92,5±20,1). 

These preliminary data, while confirming that multiple hormonal deficiencies are associated with the severity of HF(1,2), suggest that an increased antioxidant defence can be observed in patients with only one anabolic hormone deficiency, but this system could not be effective in contrasting the ingravescence of the hormonal picture, perhaps contributing, in a reciprocal way, to influence hormone levels themselves


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