Paradox of circulating advanced glycation end product concentrations in patients with congestive heart failure and after heart transplantation

Objectives: To analyse circulating concentrations of advanced glycation end products (AGEs) in patients with severe congestive heart failure (CHF) and after heart transplantation; to identify the potential contribution of kidney function to plasma AGE concentrations; and to determine whether AGE con...

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Bibliographic Details
Published in:Heart (British Cardiac Society) 2004-11, Vol.90 (11), p.1269-1274
Main Authors: Heidland, A, Šebeková, K, Frangiosa, A, De Santo, L S, Cirillo, M, Rossi, F, Cotrufo, M, Perna, A, Klassen, A, Schinzel, R, De Santo, N G
Format: Article
Language:English
Subjects:
Adolescent
Adult
advanced glycation end product
advanced oxidation protein product
AGE
AGE associated fluorescence
Alzheimer's disease
AOPP
Binding sites
Biological and medical sciences
Blood pressure
BMI
body mass index
carboxymethyllysine
Cardiology. Vascular system
Cardiovascular disease
Cardiovascular Medicine
CHF
CML
congestive heart failure
Cross-Sectional Studies
Cytokines
Diabetes
ELISA
enzyme linked immunosorbent assay
Enzymes
Female
GFR
glomerular filtration rate
Glomerular Filtration Rate - physiology
Glycation End Products, Advanced - blood
Heart
Heart failure
Heart Failure - blood
Heart Failure - physiopathology
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart Transplantation
Humans
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - physiopathology
Lipid Peroxidation
Long term
Lysine - analogs & derivatives
Lysine - blood
Male
Medical prognosis
Medical sciences
Middle Aged
Mortality
Nε-(carboxymethyl)lysine
Oxidative stress
Patients
Proteins
Spectrum analysis
TNF α
Transplants & implants
tumour necrosis factor α
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Summary:Objectives: To analyse circulating concentrations of advanced glycation end products (AGEs) in patients with severe congestive heart failure (CHF) and after heart transplantation; to identify the potential contribution of kidney function to plasma AGE concentrations; and to determine whether AGE concentrations and parameters of oxidative stress are interrelated. Methods and results: Circulating Nε-(carboxymethyl)lysine (CML) and AGE associated fluorescence (AGE-Fl), lipid peroxidation, and glomerular filtration rate (GFR) were measured in a cross sectional study of 22 patients with advanced CHF, 30 heart transplant recipients, and 20 healthy controls. Compared with the controls, the CHF patients had decreased CML (mean (SEM) 467.8 (20.0) ng/ml v 369.3 (22.3) ng/ml, p < 0.01), AGE-Fl (mean (SEM) 302.2 (13.3) arbitrary units v 204.9 (15.7) arbitrary units, p < 0.01), and GFR (p < 0.01). CML was positively related to decreased total protein and serum albumin and negatively to body mass index (p < 0.01). In contrast, in the heart transplant group, impaired GFR was associated with a notable rise of both CML (mean (SEM) 876.1 (53.1) ng/ml, p < 0.01) and AGE-Fl (mean (SEM) 385.6 (26.1) arbitrary units, p < 0.01). A positive relation between CML and serum albumin (r  =  0.394, p < 0.05) and lipofuscin (r  = 0.651, p < 0.01) was found. Conclusions: The contrasting concentration of CML and AGE-Fl between patients with CHF and after heart transplantation in the presence of decreased GFR and oxidative stress are explained by lowered plasma proteins in CHF and higher concentrations in heart transplant recipients. In heart transplant recipients, in addition to myocardial inflammatory processes, immunosuppression may be important for enhanced formation of AGEs.
ISSN:1355-6037
1468-201X
DOI:10.1136/hrt.2003.026989