| Objective: To study the changes and clinical significance of glutathione redox-statein patients with chronic heart failure.Methods: Total of 109 hospitalized patients in cadiovascular wards of the firstaffiliated hospital of suzhou university from May. 2006 to Mar. 2007 was selected. Basedon with and without organic heart disease and the heart function, they were classified into2 groups: chronic heart failure (CHF) group (n=81) and control group (n=28). According toNYHA heart function grade (Ⅱ,Ⅲ,Ⅳ), CHF group was divided into 3 subgroups.Samples of peripheral venous blood with heparin as anticoagulant were obtained fromaforesaid patients on empty stomach in next morning after they have been hospitalized,then the samples were centrifuged and the plasma concentration of GSH and GSSG wasdetermined by using glutathione reductase recycling method(GR-DTNB). Redox potential(EhGSH/GSSG) was calculated using Nemst equation according to the concentration ofreduced and oxidized glutathione. At the same time samples of peripheral venous bloodwere obtained to determine the concentration of uric acid,glutamate-pyruvatetransaminase (ALT),camine (Cr),cholesterol (TC) etc. All patients undertookechocardiography examination and LAD,LVEF,LVEDD,IVST,LVPWT were measured.Results: 1. The concentration of GSH was significantly lower in CHFgroup[(4.90±0.56)μM vs (6.78±0.76)μM], (p＜0.001) compared with control group, whilethe concentration of GSSG and the value of EhGSH/GSSG were higher in CHF group[(1.30±0.15)μM vs (1.044±1.42)μM], (p＜0.001) and[(-122.92±4.37) mV vs(-133.674±3.49) mV], (p＜0.001).2. There was a significant difference between heart function gradeⅡandⅢ,ⅣinCHF subgroups in concentration of GSH,GSSG and value of EhGSH/GSSG, though therewas no difference betweenⅢandⅣsubgroups, there had an increase trend. 3. The concentration of GSH had a positive correlation with LVEF (r=0.670,p＜0.001) and a negative correlation with LVEDD (r=-0.466, p＜0.001); GSSG and LVEFwere negatively correlated (r=-0.607, p＜0.001), GSSG and LVEDD were positivelycorrelated (r=0.433, p＜0.001); EhGSH/GSSG and LVEF were negatively correlated (r=-0.615,p＜0.001), EhGSH/GSSG and LVEDD were positively correlated (r=0.616, p＜0.001).4. There was a significant difference between control and CHF group in the level ofblood uric acid [(310.54±99.92)μM vs (499.09±168.06)μM],(p＜0.001). Uric acid had anegative correlation with LVEF (r=-0.247, p=0.026), and a positive correlation withLVEDD (r=0.266, p=0.016). Moreover the concentration of uric acid and GSH werenegatively correlated (r=-0.328, p=0.003), the concentration of uric acid and EhGSH/GSSGwere positively correlated (r=0.309, p=0.005).Conclusions: 1. The concentration of GSH decreased in CHF patients, while theconcentration of GSSG and the value of EhGSH/GSSG increased, suggesting there had anincrease of oxidative stress in CHF patients and an imbalance in antioxidation andprooxidation in the progression of CHF.2. Plasma concentration of GSH,GSSG and the value of EhGSH/GSSG all had acorrelation with heart function. Among these the EhGSH/GSSG had the closest correlation, itmay be used as a marker to reflect heart function and the serious degree of CHF.3. The concentration of uric acid increased in CHF patients and had a positivecorrelation with heart function grade and the serious degree of CHF, it also may be amarker to reflect heart function and the serious degree of CHF. The concentration of uricacid also had a negative correlation with GSH, and a positive correlation with the value ofEhGSH/GSSG. The concentration of uric acid may be used as an indicator of oxidative stresscombing with its metabolic pathway.
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