Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
J Card Fail. 2009 Nov;15(9):770-4. doi: 10.1016/j.cardfail.2009.05.009. Epub 2009 Jul 3.
Oxidative stress appears to play a significant role in the pathogenesis of heart failure (HF). Antibodies to oxidized low-density lipoprotein (Ox LDL Abs) reflect an immune response to LDL over a prolonged period and may thus represent oxidative stress over an extended time. Ox LDL Abs have been shown to correlate with clinical control in HF patients. We evaluated the predictive power of Ox LDL Abs on the outcome in patients with HF.
Baseline levels of Ox LDL Abs were determined by enzyme-linked immunosorbent assay in 284 consecutive outpatients with severe chronic HF who were being treated in the cardiology services of our medical center. Their mean New York Heart Association (NYHA) Class was 2.8. The mean follow-up for the group was 3.7 years, during which 107 (37%) died. The mean time from symptom onset to first hospital admission from HF was 25.8 months. Ox LDL Abs were found to predict morbidity and mortality as evaluated by a Cox multivariate regression analysis with a hazard ration of 1.013 (P < .013), whereas N-terminal pro-B-type natriuretic peptide (NT pro-BNP) levels achieved a HR of 1.028 (P < .099).
Ox LDL Abs level maybe a useful parameter for monitoring and planning better management of patients with HF. It was superior to pro-BNP as a predictor of clinical course as expressed by time to hospitalization.
氧化应激似乎在心力衰竭（HF）的发病机制中起重要作用。氧化型低密度脂蛋白（Ox LDL）抗体反映了对 LDL 的长期免疫反应，因此可能代表了长时间的氧化应激。Ox LDL 抗体已被证明与 HF 患者的临床控制相关。我们评估了 Ox LDL 抗体对 HF 患者预后的预测能力。
通过酶联免疫吸附试验（ELISA）在我院心血管科就诊的 284 例重度慢性 HF 连续门诊患者中测定 Ox LDL 抗体的基线水平。他们的平均纽约心脏协会（NYHA）分级为 2.8。该组的平均随访时间为 3.7 年，期间有 107 例（37%）死亡。从 HF 症状发作到首次入院的平均时间为 25.8 个月。通过 Cox 多变量回归分析发现 Ox LDL 抗体可预测发病率和死亡率，危险比为 1.013（P <.013），而 N 末端前 B 型利钠肽（NT pro-BNP）水平的危险比为 1.028（P <.099）。
Ox LDL 抗体水平可能是监测和计划更好地管理 HF 患者的有用参数。与 pro-BNP 相比，它作为住院时间的临床病程预测指标更优。
