ELEVATED LEVELS OF 8-ISO-PROSTAGLANDIN F2-ALPHA IN PERICARDIAL FLUID OF PATIENTS WITH HEART-FAILURE - A POTENTIAL ROLE FOR IN-VIVO OXIDANT STRESS IN VENTRICULAR DILATATION AND PROGRESSION TO HEART-FAILURE

Background-It has been suggested that oxidant stress may play a role i n the pathophysiology of heart failure. However, no definitive informa tion is available because most previous approaches used to measure oxi dant stress are nonspecific, inaccurate, and unreliable. Methods and R esults-To evaluate oxidant stress in the heart, we measured pericardia l fluid levels of 8-iso-prostaglandin F-2 alpha (8-iso-PGF(2 alpha)), a specific and quantitative marker of oxidant stress in vivo, in a ser ies of 51 consecutive patients with ischemic and/or valvular heart dis ease referred for cardiac surgery. Pericardial levels of 8-iso-PGF(2 a lpha) were correlated with the functional severity of heart failure (N YHA classification) and with echocardiographic indices of ventricular dilatation measured by independent physicians. Pericardial levels of 8 -iso-PGF(2 alpha) were significantly increased in patients with sympto matic heart failure compared with asymptomatic patients and gradually increased with the functional severity of heart failure (P=.0003). In addition, pericardial levels of 8-iso-PGF(2 alpha) were significantly correlated with left ventricular end-diastolic and end-systolic diamet ers (P=.008 and .026, respectively). Conclusions-Pericardial levels of 8-iso-PGF(2 alpha) increase with the functional severity of heart fai lure and are associated with ventricular dilatation. These data sugges t an important role for in vivo oxidant stress on ventricular remodeli ng and the progression to heart failure.