Plasma xanthine oxidoreductase activity in patients with decompensated acute heart failure requiring intensive care

Abstract

Aims Plasma xanthine oxidoreductase (XOR) activity during the acute phase of acute heart failure (AHF) requires further elucidation. Methods and results One hundred eighteen AHF patients and 231 control patients who attended a cardiovascular outpatient clinic were prospectively analysed. Blood samples were collected within 15 min of admission from AHF patients (AHF group) and control patients who visited a daily cardiovascular outpatient clinic (control group). Plasma XOR activity was compared between the two groups, and factors independently associated with extremely elevated XOR activity were identified using a multivariate logistic regression model. Plasma XOR activity in the AHF group (median, 104.0 pmol/h/mL; range, 25.9–423.5 pmol/h/mL) was significantly higher than that in the control group (median, 45.2 pmol/h/mL; range, 19.3–98.8 pmol/h/mL). The multivariate logistic regression model showed that serum uric acid (per 1.0 mg/dL increase, odds ratio: 1.280; 95% confidence interval: 1.066–1.536; P = 0.008) and lactate levels (per 1.0 mmol/L increase, odds ratio: 1.239; 95% confidence interval: 1.040–1.475; P = 0.016) were independently associated with high plasma XOR activity (>300 pg/h/mL) during the acute phase of AHF. Conclusions Plasma XOR activity was extremely high in patients with severely decompensated AHF. This would be associated with a high lactate value and would eventually lead to hyperuricaemia in patients with AHF.

Characteristics of Patients with an Abnormally Decreased Plasma Xanthine Oxidoreductase Activity in Acute Heart Failure Who Visited the Emergency Department

“…We previously reported that plasma XOR activity was extremely high in patients with severely decompensated AHF [4]. We also pointed out in that study that some cases had an extremely low XOR activity on admission.…”

“…We previously reported that extremely high levels of plasma XOR activity were present in patients with AHF [4]. Lactate is associated with extremely high levels of XOR.…”

“…A plasma XOR activity assay was performed using a stable isotope-labeled substrate and liquid chromatography triple quadrupole mass spectrometry (LC-TQMS; Sanwa Kagaku Kenkyusho Co. Ltd., Mie, Japan). The methods for the evaluation of a plasma XOR activity assay have been described previously [4].…”

Time‐dependent changes in plasma xanthine oxidoreductase during hospitalization of acute heart failure

“…The AHF patients were divided into two groups according to the XOR activity on Day 1: the high‐XOR group (≥100 pmol/h/mL, n = 102) or the low‐XOR group (<100 pmol/h/mL, n = 85). Because the normal range of XOR activity was not established yet, cut‐off value (100 pmol/h/mL) of the present study was defined by the reference of the previous reports in patients with AHF, which the median plasma XOR activity was 77.0 and 104.0 pmol/h/mL, respectively 4,7 . Furthermore, 85 high‐XOR patients were assigned to two groups according to the rate of change in XOR from Day 1 to Day 14: the decreased group (≥50% decrease, n = 70) and the non‐decreased group (<50% decrease, n = 15).…”

Urate-lowering therapy for heart failure

“…Активность КОР плазмы во время острой фазы СН была оценена H. Okazaki и соавт. [31], которые обследовали 118 больных с острой СН (ОСН) и 231 пациента группы контроля, наблюдавшихся в отделении кардиологии. Активность КОР была чрезвычайно высокой у пациентов с тяжелой декомпенсированной ОСН, что связано с высоким уровнем лактата и приводило к развитию ГУ.…”