Abstract 10870: The Utility of Reactive Oxygen Metabolites as a Predictor of Severity of Heart Failure and Future Cardiovascular Event in Heart Failure With Preserved Ejection Fraction
Background: Reactive oxygen species (ROS) is known to contribute to the development of ventricular dysfunction in patients with heart failure (HF). Derivatives of reactive oxygen metabolites (d-ROMs), reflecting hydroperoxide levels, is a newly and easier-to-assay marker of ROS. We investigated the associations of d-ROMs with the severity of HF and future cardiovascular events.
Methods: We enrolled 221 patients with HF with preserved ejection fraction (HFPEF) who were referred to Kumamoto University Hospital between April 2007 and April 2013. We classified HFPEF patients by New York Heart Association (NYHA) functional class for evaluation of the severity of HFPEF and measured d-ROMs value at the stable condition. HFPEF patients were prospectively followed until occurrence of cardiovascular events (cardiovascular death, non-fatal myocardial infarction, unstable angina pectoris, non-fatal ischemic stroke, hospitalization for HF, or coronary revascularization).
Results: d-ROMs value was significantly higher in HFPEF patients compared with control subjects [HFPEF (n=221): 357.1±70.7 vs. control subjects (n=93): 324.7±57.7, p<0.001], and associated with the severity of HFPEF [NYHA II (n=177): 342.3±53.3 vs. NYHA III/IV (n=44): 416.5±97.3, p<0.001]. Furthermore, during mean 18 months follow-up, 56 cardiovascular events were recorded. Kaplan-Meier analysis demonstrated a significantly higher probability of cardiovascular events in the high d-ROMs value group than low d-ROMs group (log-rank test p=0.02). By univariate Cox hazard analysis, six variables were identified as significant predictors (hemoglobin, B-type natriuretic peptide, d-ROMs value, NYHA functional class, atrial fibrillation, history of hospitalization for HF). By multivariate Cox hazard analysis including these predictors, d-ROMs value was independently predicted future cardiovascular events (hazard ratio 1.05, 95% confidence interval 1.02-1.09, p=0.003).
Conclusion: d-ROMs value was significantly increased in patients with HFPEF and was associated with its severity. Furthermore d-ROMs value was correlated with future cardiovascular events in patients with HFPEF, indicating useful cardiovascular event risk predictor.
- © 2013 by American Heart Association, Inc.