The Oxidative Status of Children with Acyanotic Congenital Heart Diseases: A Randomized Controlled Study

Authors

  • Ayhan Pektaş Afyon Kocatepe University Hospital
  • Halit B. Koca Afyon Kocatepe University Hospital
  • Bilgehan M. Pektas Afyon Kocatepe University Hospital
  • Reşit Köken Afyon Kocatepe University Hospital

Abstract

Objective: This study aims to investigate the role of oxidative stress congenital heart defects with left-to-right shunt by determining total oxidant status (TOS), total antioxidant status and oxidative stress index (OSI) in affected children.

Methods: This is a prospective, randomized case-control study which reviews 40 healthy children and 40 children who have congenital heart defects with left-to-right shunt.

Results: The healthy children and the children who have congenital heart defects with left-to-right shunt are statistically similar with respect to age, sex, height, weight and body mass index (p>0.05 for all). Both groups have statistically similar echocardiography findings including interventricular septum thickness, left ventricular internal diameter, left ventricular posterior wall, systolic volume, end diastolic volume, fractional shortening, ejection fraction and left ventricular mass values (p>0.05 for each). These groups are also statistically similar in aspect of myocardial performance index, E´, A´, S´, relaxation time and contraction time values that have been specified for left ventricle, interventricular septum and right ventricle (p>0.05 for each). The healthy children and the children with congenital heart defects have statistically similar blood count parameters as well as serum concentrations of vitamin D and brain natriuretic peptide. The children who have congenital heart defects with left-to-right shunt have significantly higher TOS and OSI values than those of the healthy children (respectively, 35.6±2.8 nmol H2O2 equiv/mg protein vs 16.1±4.6 nmol H2O2 equiv/mg protein, p=0.018 and 32.4±1.4 vs 11.5±3.2, p=0.022).  

Conclusion: The imbalance between the prooxidant and antioxidant reactions causes an enhancement in oxidative stress which may contribute to the pathogenesis of congenital heart defects with left-to-right shunting.

Author Biographies

Ayhan Pektaş, Afyon Kocatepe University Hospital

Department of Pediatric Cardiology

Halit B. Koca, Afyon Kocatepe University Hospital

Department of Biochemistry

Bilgehan M. Pektas, Afyon Kocatepe University Hospital

Department of Pharmacology

Reşit Köken, Afyon Kocatepe University Hospital

Department of Pediatric Neurology

References

Bertoletti J, Marx GC, Hattge SP, Pellanda LC. Health-related quality of life in adolescents with congenital heart disease. Cardiol Young 2015; 25: 526-32.

Majnemer A, Limperopoulos C, Shevell MI, Rohlicek C, Rosenblatt B, Tchervenkov C. A new look at outcomes of infants with congenital heart disease. Pediatr Neurol 2009; 40: 197-204.

Rao PS. Consensus on timing of intervention for common congenital heart diseases: part I acyanoticheart defects. Indian J Pediatr 2013; 80: 32-8.

Favilli S, Santoro G, Ballo P, Arcangeli C, Bovenzi FM, Chiappa E, Conti U, Monopoli A, Murzi B, Rosini C, Zuppiroli A. Prevalence and clinical characteristics of adult patients with congenital heart disease in Tuscany. J Cardiovasc Med (Hagerstown) 2012; 13: 805-9.

Gutterman DD, Chabowski DS, Kadlec AO, Durand MJ, Freed JK, Ait-Aissa K, Beyer AM. The human microcirculation: Regulation of flow and beyond. Circ Res 2016; 118: 157-72.

Kvietys PR, Granger DN. Role of reactive oxygen and nitrogen species in the vascular responses to inflammation. Free Radic Biol Med 2012; 52: 556-92.

Piedrafita G, Keller MA, Ralser M. The impact of non-enzymatic reactions and enzyme promiscuity on cellular metabolism during (oxidative) stress conditions. Biomolecules 2015; 5: 2101-22.

Vakilian K, Ranjbar A, Zarganjfard A, Mortazavi M, Vosough-Ghanbari S, Mashaiee S, Abdollahi M. On the relation of oxidative stress in delivery mode in pregnant women; a toxicological concern. Toxicol Mech Methods 2009; 19: 94-9.

Lurie S, Matas Z, Boaz M, Fux A, Golan A, Sadan O. Different degrees of fetal oxidative stress in elective and emergent cesarean section. Neonatology 2007; 92: 111-5.

Husain K, Hernandez W, Ansari RA, Ferder L. Inflammation, oxidative stress and renin angiotensin system in atherosclerosis. World J Biol Chem 2015; 6: 209-17.

Czerska M, Mikołajewska K, Zieliński M, Gromadzińska J, Wąsowicz W. Today's oxidative stress markers. Med Pr2015; 66: 393-405.

Erel O. A novel automated method to measure total antioxidant response against potent free radical reactions. Clin Biochem 2004; 37: 112-9.

Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem 2005; 38:1103-11.

Harma MI, Harma M, Erel O. Measuring plasma oxidative stress biomarkers in sport medicine. Eur J Appl Physiol 2006; 97: 505-8.

Calderón-Colmenero J, Sandoval Zárate J, Beltrán Gámez M. Pulmonary hypertension associated with congenital heart disease and Eisenmenger syndrome. Arch Cardiol Mex 2015; 85:32-49.

Aburawi EH, Pesonen E. Pathophysiology of coronary blood flow in congenital heart disease. Int J Cardiol 2011; 151: 273-7.

Aggarwal S, Gross C, Fineman JR, Black SM. Oxidative stres and the development of endothelial dysfunction in congenital heart disease with increased pulmonary blood flow: lessons from the neonatal lamb. Trends Cardiovasc Med 2010; 20: 238-46.

Opotowsky AR. Clinical evaluation and management of pulmonary hypertension in the adult with congenital heart disease. Circulation 2015; 131: 200-10.

Karatas Z, Baysal T, Sap F, Altin H, Cicekler H. The role of tenascin-C and oxidative stress in rheumatic and congenital heart valve diseases: an observational study. Anadolu Kardiyol Derg 2013; 13: 350-6.

Rokicki W, Strzałkowski A, Kłapcińska B, Danch A, Sobczak A. Antioxidant status in newborns and infants suffering from congenital heart defects. Wiad Lek 2003; 56: 337-40.

Ercan S, Cakmak A, Kösecik M, Erel O. The oxidative state of children with cyanotic and acyanotic congenital heart disease. Anadolu Kardiyol Derg 2009; 9: 486-90.

Ceriello A. New insights on oxidative stress and diabetic complications may lead to a "causal" antioxidant therapy. Diabetes Care 2003; 26: 1589-96.

Saedisomeolia A, Taheri E, Djalali M, Djazayeri A, Qorbani M, Rajab A, Larijani B. Vitamin D status and its association with antioxidant profiles in diabetic patients. A cross-sectional study in Iran. Indian J Med 2013; 67: 29-37.

Chiavaroli V, Giannini C, De Marco S, Chiarelli F, Mohn A. Unbalanced oxidant-antioxidant status and its effects in pediatric diseases. Redox Rep 2011; 16: 101-7.

Salzano S, Checconi P, Hanschmann EM, Liilig CH, Bowler LD, Chan P, Vaudry D, Mengozzi M, Coppo L, Sacre S, Atkuri KR, Sahaf B, Herzenberg LA, Mullen L, Ghezzi P. Linkage of inflammation and oxidative stres via release of glutathionylated peroxiredoxin-2, which acts as a danger signal. Proc Natl Acad Sci USA 2014; 111: 12157-62.

Morrison D, Rahman I, MacNee W. Permeability, inflammation and oxidant status in airspace epithelium exposed to ozone. Respir Med 2006; 100: 2227-34.

Aktas G, Alcelik A,Kin Tekce B, Tekelioglu V, Sit M, Savli H. Red cell distribution width and mean platelet volume in patients with irritable bowel syndrome. Prz Gastroenterol 2014; 9: 160-3.

Ahbap E, Sakaci T, Kara E, Sahutoglu T, Koc Y, Basturk T, Sevinc M, Akgol C, Kayalar AO, Ucar ZA, Bayraktar F, Unsal A. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in evaluation of inflammation in end-stage renal disease. Clin Nephrol 2015 Nov 2 (Epub ahead of print).

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Published

23.06.2016

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Original Research