Abstract
The aim of the present study was to assess the antioxidant capacity in the serum and pericardial fluid of patients undergoing heart surgery for coronary heart disease (CHD) or valvular heart disease (VHD) and to find out whether there are gender-related differences in the antioxidant defense. This study involved 85 patients (35 VHD and 50 CHD) undergoing elective heart surgery. Blood samples from the peripheral vein and from the pericardial fluid were taken intraoperatively. Variables determined in the serum and pericardial fluid were: total protein, albumin, uric acid and antioxidant capacity. In the total patient population the antioxidant capacity in the pericardial fluid was lower than in the serum but still relatively high as determined by two independent techniques. No major differences were seen in serum or pericardial fluid antioxidant capacity between the two patient groups. In the overall patient population uric acid (p < 0.05), albumin (p < 0.01) and total protein concentrations (p < 0.01) were, however, significantly greater in the pericardial fluid of male than of female patients. The pericardial fluid may contribute to the local antioxidant defense of the myocardium. It appears that male gender confers advantage in this respect. It remains to be elucidated whether this finding has any implication for the higher risk for women of perioperative complications and of cardiovascular mortality after coronary bypass grafting or coronary angioplasty.
References
1 Hill MF, Singal PK. Right and left myocardial antioxidant responses during heart failure subsequent to myocardial infarction. Circulation 1997; 96:2414–20.10.1161/01.CIR.96.7.2414Search in Google Scholar
2 Hoeschen RJ. Oxidative stress and cardiovascular disease. Can J Cardiol 1997; 13:1021–5.Search in Google Scholar
3 Sharma SB, Dwivedi S, Kumar N, Prabhu KM, Madan N. Studies on oxidative stress, serum iron and iron binding capacity in subjects prone to the risk of coronary artery disease. Indian Heart J 2000; 52:583–6.Search in Google Scholar
4 Heitzer T, Schlinzig T, Krohn K, Meinertz T, Munzel T. Endothelial dysfunction, oxidative stress, and risk of cardiovascular events in patients with coronary artery disease. Circulation 2001; 104:2673–8.10.1161/hc4601.099485Search in Google Scholar
5 Landmesser U, Merten R, Spiekermann S, Buttner K, Drexler H, Hornig B. Vascular extracellular superoxide dismutase activity in patients with coronary artery disease: relation to endothelium-dependent vasodilation. Circulation 2000; 101:2264–70.10.1161/01.CIR.101.19.2264Search in Google Scholar
6 Mayer M. Association of serum bilirubin concentration with risk of coronary artery disease. Clin Chem 2000, 46:1723–7.10.1093/clinchem/46.11.1723Search in Google Scholar
7 Nojiri S, Daida H, Mokuno H, Iwana Y, Mae K, Ushio F, et al. Association of serum antioxidant capacity with coronary artery disease in middle-aged men. Jpn Heart J 2001; 42:677–90.10.1536/jhj.42.677Search in Google Scholar
8 Krijgsman B, Papadakis JA, Ganotakis ES, Mikhailidis DP, Hamilton G. The effect of peripheral vascular disease on the serum levels of natural antioxidants: bilirubin and albumin. Int Angiol 2002; 21:44–52.Search in Google Scholar
9 Hughes K, Lee BL, Feng X, Lee J, Ong CN. Coenzyme Q10 and differences in coronary heart disease risk in Asian Indians and Chinese. Free Radic Biol Med 2002; 32:132–8.10.1016/S0891-5849(01)00783-3Search in Google Scholar
10 Miller NJ, Rice-Evans C, Davies MJ, Gopinathan V, Milner A. A novel method for measuring antioxidant capacity and its application to monitoring the antioxidant status in premature neonates. Clin Sci 1993; 84:407–12.10.1042/cs0840407Search in Google Scholar PubMed
11 Kambam JR, Merrill W, Parris W, Alhaddad R, Naukam R, Stewart J, et al. Substance P, acethylcholinesterase, and β-endorphin levels in the plasma and pericardial fluid of patients with and without angina pectoris. J Lab Clin Med 1990; 116:707–10.Search in Google Scholar
12 Driver AG, Kukoly CA, Spence PA, Chitwood WR, Mustafa SJ. Pericardial fluid adenosine in ischemic and valvular heart disease. Chest 1995; 107:346–51.10.1378/chest.107.2.346Search in Google Scholar PubMed
13 Fujita M, Ikemoto M, Kishishita M, Otani H, Nohara R, Tanaka T, et al. Elevated basic fibroblast growth factor in pericardial fluid of patients with unstable angina. Circulation 1996; 94:610–3.10.1161/01.CIR.94.4.610Search in Google Scholar PubMed
14 Mallat Z, Philip I, Lebret M, Chatel D, Maclouf J, Tedgui A. Elevated levels of 8-iso-prostaglandin F2α in pericardial fluid of patients with heart failure. Circulation 1998; 97:1536–9.10.1161/01.CIR.97.16.1536Search in Google Scholar
15 Horkay F, Szokodi I, Selmeci L, Merkely B, Kékesi V, Vecsey T, et al. Presence of immunoreactive endothelin-1 and atrial natriuretic peptide in human pericardial fluid. Life Sci 1998; 62:267–74.10.1016/S0024-3205(97)01105-3Search in Google Scholar
16 Fazekas L, Horkay F, Kékesi V, Huszár E, Barát E, Fazekas R, et al. Enhanced accumulation of pericardial fluid adenosine and inosine in patients with coronary artery disease. Life Sci 1999; 65:1005–12.10.1016/S0024-3205(99)00331-8Search in Google Scholar
17 Selmeci L, Antal M, Horkay F, Merkely B, Szokodi I, Bíró L, et al. Enhanced accumulation of pericardial fluid fer ritin in patients with coronary artery disease. Coronary Artery Dis 2000; 11:53–6.10.1097/00019501-200002000-00010Search in Google Scholar
18 Iwakura A, Fujita M, Hasegawa K, Sawamura T, Nohara R, Sasayama S, et al. Pericardial fluid from patients with unstable angina induces vascular cell apoptosis. J Am Coll Cardiol 2000; 35:1785–90.10.1016/S0735-1097(00)00651-3Search in Google Scholar
19 Klemola R, Tikkanen I, Vuolteenaho O, Toivonen L, Laine M. Plasma and pericardial fluid natriuretic peptide levels in postinfarction ventricular dysfunction. Eur J Heart Fail 2001; 3:21–6.10.1016/S1388-9842(00)00090-8Search in Google Scholar
20 Oyama J, Shimokawa H, Morita S, Yasui H, Takeshita A. Elevated interleukin-1beta in pericardial fluid of patients with ischemic heart disease. Coronary Artery Dis 2001; 12:567–71.10.1097/00019501-200111000-00007Search in Google Scholar
21 Tambara K, Fujita M, Nagaya N, Miyamoto S, Iwakura A, Doi K, et al. Increased pericardial fluid concentrations of the mature form of adrenomedullin in patients with cardiac remodeling. Heart 2002; 87:242–6.10.1136/heart.87.3.242Search in Google Scholar
22 Soós P, Juhász-Nagy A, Ruskoaho H, Hartyánszky I, Merkely B, Tóth M, et al. Locally different role of atrial natriuretic peptide (ANP) in the pericardial fluid. Life Sci 2002; 71:2563–73.10.1016/S0024-3205(02)02088-XSearch in Google Scholar
23 Fujita M, Komeda M, Hasegawa K, Kihara Y, Nohara R, Sasayama S. Pericardial fluid as a new material for clinical heart research. Int J Cardiol 2001; 77:113–8.10.1016/S0167-5273(00)00462-9Search in Google Scholar
24 Koracevic D, Koracevic G, Djordjevic V, Andrejevic S, Cosic V. Method for the measurement of antioxidant activity in human fluids. J Clin Pathol 2001; 54:356–61.10.1136/jcp.54.5.356Search in Google Scholar PubMed PubMed Central
25 Polidori MC, Savino K, Alunni G, Freddio M, Senin U, Sies H, et al. Plasma lipohilic antioxidants and malondialdehyde in congestive heart failure patients: relationship to disease severity. Free Radic Biol Med 2002; 32:148–52.10.1016/S0891-5849(01)00782-1Search in Google Scholar
26 Liese AD, Hense HW, Lowel H, Doring A, Tietze M, Keil U. Association of serum uric acid with all-cause and cardiovascular disease mortality and incident myocardial infarction in the MONICA Augsburg cohort. World Health Organization Monitoring Trends and Determinants in Cardiovascular Diseases. Epidemiology 1999; 10:391–7.10.1097/00001648-199907000-00009Search in Google Scholar
27 Alderman M. Uric acid in hypertension and cardiovascular disease. Can J Cardiol 1999; 15:Suppl F:20F–22F.Search in Google Scholar
28 Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med 1999; 131:7–13.10.7326/0003-4819-131-1-199907060-00003Search in Google Scholar
29 Leyva F, Anker SD, Godsland IF, Teixeira M, Hellewell PG, Kox WJ, et al. Uric acid in chronic heart failure: a marker of chronic inflammation. Eur Heart J 1998; 19:1814–22.10.1053/euhj.1998.1188Search in Google Scholar
30 Nieto FJ, Iribarren C, Gross MD, Comstock GW, Cutler RG. Uric acid and serum antioxidant capacity: a reaction to atherosclerosis? Atherosclerosis 2000; 148:131–9.10.1016/S0021-9150(99)00214-2Search in Google Scholar
31 Waring WS, Webb DJ, Maxwell SR. Systemic uric acid administration increases serum antioxidant capacity in healthy volunteers. J Cardiovasc Pharmacol 2001; 38:365–71.10.1097/00005344-200109000-00005Search in Google Scholar
32 Williams MR, Choudri AF, Morales DL, Helman DN, Oz MC. Gender differences in patients undergoing coronary artery bypass surgery, from a mandatory statewide database. J Gend Specif Med 2000; 3:41–8.Search in Google Scholar
33 Abramov D, Tamariz MG, Sever JY, Christakis GT, Bhatnagar G, Heenan AL, et al. The influence of gender on the outcome of coronary artery bypass surgery. Ann Thorac Surg 2000; 70:800–5.10.1016/S0003-4975(00)01563-0Search in Google Scholar
34 Feldman T, Silver R. Gender differences and the outcome of interventions for acute coronary syndromes. Cardiol Rev 2000; 8:240–7.10.1097/00045415-200008040-00009Search in Google Scholar
35 Jensen J, Eriksson SV, Lindvall B, Lundin P, Sylven C. Women react with more myocardial ischemia and angina pectoris during elective percutaneous transluminal coronary angioplasty. Coron Artery Dis 2000; 11:527–35.10.1097/00019501-200010000-00003Search in Google Scholar
36 Hartz RS, Rao AV, Plomondon ME, Grover FL, Shroyer AL. Effects of race with or without gender, on operative mortality after coronary artery bypass grafting: a study using The Society of Thoracic Surgeons National Database. Ann Thorac Surg 2001; 71:512–20.10.1016/S0003-4975(00)02030-0Search in Google Scholar
37 Zaroff JG, di Tommaso DG, Barron HV. A risk model derived from the National Registry of Myocardial infarction 2 database for predicting mortality after coronary artery bypass grafting during acute myocardial infarction. Am J Cardiol 2002; 90:1–4.10.1016/S0002-9149(02)02375-5Search in Google Scholar
38 Wenger NK. Clinical characteristics of coronary heart disease in women: emphasis on gender differences. Cardiovasc Res 2002; 53:558–67.10.1016/S0008-6363(01)00511-9Search in Google Scholar
39 Krstevska M, Dzhekova-Stojkova S, Bosilkova G. Menopause, coronary artery disease and antioxidants. Clin Chem Lab Med 2001; 39:641–4.10.1515/CCLM.2001.104Search in Google Scholar
40 Block G, Dietrich M, Norkus EP, Morrow JD, Hudes M, Caan B, et al. Factors associated with oxidative stress in human populations. Am J Epidemiol 2002; 156:274–85.10.1093/aje/kwf029Search in Google Scholar
41 Ward NC, Hodgson JM, Puddey IB, Mori TA, Beilin LJ, Croft KD. Oxidative stress in human hypertension: association with antihypertensive treatment, gender, nutrition, and lifestyle. Free Radic Biol Med 2004; 36:226–32.10.1016/j.freeradbiomed.2003.10.021Search in Google Scholar
42 Marra G, Cotroneo P, Pitocco D, Manto A, Di Leo MA, Ruotolo V, et al. Early increase of oxidative stress and reduced antioxidant defense in patients with uncomplicated type 1 diabetes: a case for gender difference. Diabetes Care 2002; 25:370–5.10.2337/diacare.25.2.370Search in Google Scholar
43 Prior RL, Cao G. In vivo total antioxidant capacity: comparison of different analytical methods. Free Radic Biol Med 1999; 27:1173–81.10.1016/S0891-5849(99)00203-8Search in Google Scholar
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