OXY FREE-RADICAL SYSTEM IN HEART-FAILURE AND THERAPEUTIC ROLE OF ORALVITAMIN-E

Twenty patients of heart failure and ten matched healthy controls were included in the trial. Out of these 20 patients of heart failure, 12 patients were also studied prospectively. Plasma levels of superoxide anion and malonyldialdehyde were increased while the levels of superox ide dismutase, catalase and glutathione reductase were decreased in pa tients of heart failure as compared to control subjects. The alteratio n in oxidative stress and antioxidant system did not correlate with th e age and sex of patients or the etiology of heart failure. With the i ncreasing severity of heart failure the malonyldialdehyde and superoxi de anion increased significantly and catalase, glutathione reductase a nd superoxide dismutase levels decreased. The soup of heart failure pa tients with ejection fraction <40% (n=7) exhibited significantly highe r levels of malonyldialdehyde than those with an ejection fraction >40 % (n=13). The superoxide anion and malonyldialdehyde levels were signi ficantly higher in patients of heart failure in the pre-treatment stat e as compared to those in post-treatment state. Conversely catalase, g lutathione reductase and superoxide dismutase were higher in the post- treatment period as compared to their values before treatment. The add ition of vitamin E in doses of 400 mg once a day orally for 4 weeks si gnificantly reduced the malonyldialdehyde and superoxide anion levels and produced an elevation of the antioxidant enzymes. Thus, there is a n apparent normalisation of the indices of oxidative stress following treatment of heart failure and a markedly improved response on vitamin E supplementation which may be more beneficial.