Elevated levels of 8-iso-prostaglandin F2α 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 in the pathophysiology of heart failure. However, no definitive information is available because most previous approaches used to measure oxidant stress are nonspecific, inaccurate, and unreliable. Methods and Results-To evaluate oxidant stress in the heart, we measured pericardial 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 series of 51 consecutive patients with ischemic and/or valvular heart disease referred for cardiac surgery. Pericardial levels of 8-iso-PGF(2 alpha) were correlated with the functional severity of heart failure (NYHA 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 symptomatic 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 diameters (P=.008 and .026, respectively). Conclusions-Pericardial levels of 8-iso-PGF(2 alpha) increase with the functional severity of heart failure and are associated with ventricular dilatation. These data suggest an important role for in vivo oxidant stress on ventricular remodeling and the progression to heart failure.