| [Objective]Heart failure (HF) is a major public health problem in our country. Epidemiological survey displays that morbidity of heart failure is still to remain rising with increasing age. Although HF may strike at any age, it is more common in people over the age of 65. Approximately 6% to 10% of people older than 65 years have HF, and approximately 80% of patients hospitalized with HF are more than 65 years old. However, there is no data available on the relation between ageing and high morbidity of HF. It is now well accepted that super-activation of neuroendocrine system contributes to the pathogenesis of chronic heart failure (CHF). Recent two decades studys indicate, moreover, that immune system and proinflammatory cytokines (e.g., tumor necrosis, interleukin-6) are also involved in the development and progression of it. Our previous studies have represented the changes of serum levels of tumor necrosis factor a (TNF- a ), sFas, ICAM1, NO and MDA and the effects of exercise test and exercise training to solubitwlity proinflammatory cytokines in patients with HF.Studies show that advanced glycation end products (AGE), advanced oxidation protein products (AOPP), maybe represent new exquisite markers of oxidative stress. AGEs can alter the structure of macrobiosis cell matrix component and result in tissue stiffness. AGEs slowly accumulates physiologically by aging, AGE accumulates in tissues and cells and thus directly damages the structure of proteins, lipids and nucleic acid, while results in the changes of their biology function. AGE is implicated in pathological conditions, particularly the vascular disease encountered in aging. Our previous studies provided that AGE can significantly increase the magnitude of apoptosis of cardiac muscle cell in a time and dose dependent manner, but the functions of AGE and AOPP in pathogenesis of HF remain unknown.In this study, the changes of blood AGE, AOPP, CRP, and plasm BNP, AVP in patients with CHF and the influence of treatment with metoprolol and carvedilol onthese patients were investigated. [Clinical data and methods]This study includes three parts: 1. The changes on serum AGE, AOPP, CRP and plasm BNP, AVP in patients with CHF; 2. The influences of of beta-blockers treatment on serum AGE, AOPP levels in patients with CHF; 3. Plasma AVP, BNP and serum AGE AOPP Levels in CHF Patients with Hyponatremia and the response of beta-blockers Therapy.By perspective study, there were 203 cases who were engaged in this study, aged from 18 to 86 years old, mean 60.82+12.83 years old, NYHA II -IV. The levels of AGE (CML), AOPP, BNP, AVP and CRP were measured and ultrasonic cardiogram were examined. On the standard therapy of chronic cardiac failure. They were divided into control group and Carvedilol group and metoprolol group at random. After 3-, 6-month, the above items were measured respectively. The serum level of AGE was measured by competitive ELISA method, Serum AOPP by spectrophotometer and plasma BNP, AVP by radio-immunity method and serum CRP by velocity scatter turbidimetry. [Result] Part one1 On the baseline, the levels of AGE (CML) ,AOPP,CRP,BNP,AVP in CHF groups were significantly higher than that of control group and obviously increased with the aggravation of heart function. There were significant deviation of the levels of plasm BNP, AVP and CRP between NYHA II, III and IV. The levels of serum AGE (CML) and AOPP in NYHA IV was higher than those of NYHA II, HI. 2 plasm AGE (CML), AOPP levels increased significantly after 65 years old.The serum level of AGE (CML) in patients with coronary heart disease (CHD) or high blood pressure (HBP) or dilated cardiomyopathy (DCM) is higher than that of rheumatic heart disease or other cardiac disease. Compare with DCM, the serum AGE (CML) levels in CHD and HBP is significant high, but not statistically significant between CHD and HBP. The level of BNP in DCM was higher than that of other cardiac disease. There were no differences of other items among different disease. The levels of AGE (CML), AOPP in CHF gro...
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