Interrelationship between renin-angiotensin-aldosterone system and oxidative stress in chronic heart failure patients with or without renal impairment

Data de publicação:

Autores da FMUP

  • Marta Fernanda Reina Couto

    Autor

  • Claudia Camila Rodrigues Pereira Dias

    Autor

  • Teresa Maria De Jesus Teixeira De Sousa

    Autor

Participantes de fora da FMUP

  • Afonso, J
  • Carvalho, J
  • Morgado, L
  • Ronchi, FA
  • Leite, APD
  • Casarini, DE
  • Bettencourt, P
  • Albino-Teixeira, A
  • Morato, M

Unidades de investigação

Abstract

We investigated oxidative stress and RAAS biomarkers, as well as their association, in chronic heart failure (CHF) patients on optimized medical therapy, stratified by disease severity or by renal function. Since vitamin D has been shown to attenuate RAAS activation and oxidative stress, we further evaluated the relationship between vitamin D, RAAS and oxidative stress in CHF patients with or without renal impairment. Sixty CHF outpatients were included and stratified by disease severity or by renal function. We quantified urinary hydrogen peroxide, plasma and urinary isoprostanes, plasma total antioxidant status, urinary angiotensinogen (intrarenal RAAS activation biomarker) and plasma angiotensinogen, plasma renin and aldosterone concentration, serum angiotensin-converting enzyme (ACE) activity, plasma angiotensin peptides, and serum total 25-hydroxyvitamin D (S-total 25(OH)D). Severe CHF patients had higher urinary isoprostanes (p = 0.002) and lower S-total 25(OH) D (p = 0.006) compared to mild-to-moderate patients, but no differences were observed for other redox or RAAS biomarkers. Patients with impaired renal function (iRF) had higher urinary angiotensinogen (p = 0.003) and lower S-total 25(OH)D (p = 0.028) compared to those with normal renal function (nRF), while no differences were observed for the remaining RAAS and redox parameters. Several positive correlations between oxidative stress and RAAS biomarkers were detected in iRF patients, while in patients with nRF these correlations were primarily inverse. In CHF-iRF patients, S-25(OD)D was inversely associated with urinary isoprostanes, which in turn were positively associated with plasma angiotensinogen and serum ACE. In conclusion, CHF patients with renal function impairment have increased intrarenal RAAS activation and lower vitamin D values and might benefit from the combination of RAAS blockers with vitamin D and/or antioxidants.

Dados da publicação

ISSN/ISSNe:
1950-6007, 1950-6007

BIOMEDICINE & PHARMACOTHERAPY  Elsevier Masson s.r.l.

Tipo:
Article
Páginas:
-
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 13

Citações Recebidas na Scopus: 19

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Keywords

  • Cardiorenal syndrome; Renin-angiotensin-aldosterone system; Oxidative stress; Urinary angiotensinogen; Vitamin D

Financiamento

Proyectos asociados

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Investigador Principal: Teresa Maria de Jesus Teixeira de Sousa

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Endocan: a novel biomarker for risk stratification, prognosis, and therapeutic monitoring in human cardiovascular and renal diseases

Investigador Principal: Teresa Maria de Jesus Teixeira de Sousa

Estudo Clínico Académico (Endocan) . 2020

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