Abstract

Objective: To investigate a novel marker of oxidative stress in patients with congestive heart failure (CHF).

Patients: 15 patients with mild CHF, 15 patients with severe CHF with acute exacerbation, and 15 control subjects.

Main outcome measures: Measurement of urinary 15-F_2t-isoprostane, plasma brain natriuretic peptide (BNP), serum interleukin 6 (IL-6), and serum thrombomodulin concentrations. In patients with severe CHF, samples were taken at admission and 4, 7, and 14 days after admission.

Results: Urinary 15-F_2t-isoprostane, plasma BNP, and serum IL-6 concentrations in patients with severe CHF were significantly higher than those in control subjects or in patients with mild CHF. However, concentrations of serum thrombomodulin, a marker of endothelial damage, were not different between patients with CHF and control subjects. In addition, urinary 15-F_2t-isoprostane, plasma BNP, and serum IL-6 concentrations in patients with severe CHF gradually decreased in proportion to the severity of CHF during hospitalisation. Interestingly, urinary 15-F_2t-isoprostane concentrations significantly correlated with plasma BNP concentrations and serum IL-6 concentrations, but not with serum thrombomodulin concentrations.

Conclusions: Urinary 15-F_2t-isoprostane concentrations increased in proportion to the severity of CHF in patients. This may be caused by increased 15-F_2t-isoprostane production. These findings suggest that urinary 15-F_2t-isoprostane may be a marker of morbidity as well as oxidative stress in patients with CHF.