Exercise-Induced Increase in Lipid Peroxidation in Patients with Chronic Heart Failure: Relation to Exercise Intolerance

Abstract

Background: Little is known about the relationship between exercise intolerance and lipid peroxidation in chronic heart failure (CHF) patients. This study was designed to investigate the relationship between exercise-induced plasma malondialdehyde (MDA) changes in CHF patients and to determine whether there is any association between plasma MDA levels and exercise capacity assessed by cardiopulmonary exercise testing. Methods: Cardiopulmonary exercise testing was applied to 31 CHF patients (16 ischemic, 15 idiopathic) and controls. Rest and peak exercise blood samples were analyzed for MDA. Results: Patients with CHF had elevation of plasma MDA levels during exercise compared with controls (p < 0.001 vs. p = 0.588). MDA change remained significant both in ischemic and idiopathic cardiomyopathy groups (p < 0.05 and p < 0.01, respectively). ΔMDA (peak exercise MDA – rest MDA) showed significant inverse correlation with peak oxygen consumption in patients with CHF. Conclusion: Lipid peroxidation is increased in patients with CHF during exercise regardless of etiology, and this increase is inversely related to oxygen consumption.

The Role of Physical Exercise and Diet Modification on Lipid Profile and Lipid Peroxidation in Long Term Glycemic Control Type 2 Diabetics

“…The lipid hydroperoxides generated by this process yield cytotoxic products such as malondialdehyde (MDA) [28]. Some studies supported our results [21] that yogic exercises have enhanced the antioxidant defense mechanism in diabetics by reducing oxidative stress [29]. Whereas some studies reported that Lipid peroxidation (LPO) is increased during exercise and this increase is inversely related to oxygen consumption.…”

Serum oxidizability potential is associated with age and exercise test results

“…A paradoxically low TCL ratio (low oxidizability potential) was observed in patients without S-T depression compared to patients with S-T depression (189±22 vs. 201± 15, p=ns), due to the fact that these patients had a much lower LVEF% and a lower exercise capacity. Regression analysis showed that older age≥70, and left ventricular EF% were the best independent predictor of the TCL ratio (R 2 =0.87208, R=0.9338, St Err=17.76, Adj F= 0.87118, n=144, p<0.001).…”

“…However, these studies disagree when pre-exercise oxidative status is examined. Sayar et al [15] failed to find a significant difference in resting plasma oxidative stress in CHF patients as compared with controls, the likely reason for these unexpected findings being that the control group contained patients with many cardiovascular risk factors rather than healthy controls. Thus, it was suggested that the underlying risk factors may be associated with an increase in resting pre-exercise plasma malondialdehyde levels.…”

“…Increased ROS production has been shown to impair endothelium-dependent vasorelaxation, to cause myocyte apoptosis, to increase monocyte adhesion, and inflammatory gene expression, thus contributing to myocardial and skeletal muscle contractile dysfunction and deterioration in congestive heart failure (CHF) patients [15].…”

“…Free radical injury has also been implicated in the pathogenesis, evolution, and progression of heart failure [9,[13][14][15]. Furthermore, with the evolution of heart failure, there is a progressive increase in free radical injury and reduction of antioxidant reserves, which impacts significantly on prognosis.…”