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Cardiac insufficiency CI is a clinic syndrome characterized by signs and symptoms of volume overload in the blood vessels and interstice which includes respiratory difficulty and inferior member edema as well as manifestations of inadequate tissue perfusionEven though the mechanisms involved in the progression of cardiac failure have not been definitively explained there is evidence to support that ventricular dysfunction worsens as a result of an increase in production of reactive oxygen species ROS and reactive nitrogen speciesROS can be formed in the heart by several mechanisms including generation during oxidative phosphorylation in the mitochondria as a secondary product of aerobic metabolism by xantine oxidase NADPH oxidases and uncoupling of NOS Despite the pathways are not fully elucidated these species are implicated in pathogenesis processes like hypertrophy impaired contraction myocyte apoptosis fibroblast proliferation deposition of extracellular matrix proteins and cardiac remodelingThe imbalance between oxidative species and antioxidant defense mechanisms in the failing myocardium resulted in the formulation of the oxidative hypothesis of CI which postulates that CI is characterized by a systemic oxidative stress causing a chronic injury which results in diminished myocardial functionOur work is based on this hypothesis and aims to determine if biomarkers related to oxidative stress are useful to estimate the severity of IC and the therapeutic response in patients with the diseaseWe have shown that there is a relation between clinical parameters used to assess CI such as left ventricle ejection fraction and functional class of the New York Heart association FC and biomarkers of oxidative stress analyzed thyols antioxidant capacity of plasma level of oxidation of hemoglobin or nitrosative stress nitrite and nitrateA depletion of thiol groups and a reduced antioxidant capacity as well as an increase in nitrite concentration in plasma was observed in patients with poor prognosis this reflects an enhanced systemic production of free radicals and may allow us to discriminate groups of patients with higher risk of an adverse event
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