Impact of plasma xanthine oxidoreductase activity in patients with heart failure with preserved ejection fraction.

Abstract

AIMS:

Reactive oxygen species are reportedly involved in the mechanism underlying heart failure with preserved ejection fraction (HFpEF); however, the disease pathophysiology remains poorly understood. Xanthine oxidoreductase (XOR), the rate-limiting enzyme of purine metabolism, plays an important role in uric acid production and generates reactive oxygen species. However, the impact of plasma XOR activity on the clinical outcomes of patients with HFpEF remains unclear. The aim of this study was to investigate whether plasma XOR activity is associated with major adverse cardiovascular events (MACEs) in patients with HFpEF.

METHODS AND RESULTS:

The plasma XOR activity was measured in 257 patients with HFpEF, who were then divided into three groups according to the activity levels: low XOR group (<33 pmol/h/mL, n = 45), normal XOR group (33-120 pmol/h/mL, n = 160), and high XOR group (>120 pmol/h/mL, n = 52). During the median follow-up period of 809 days, there were 74 MACEs. Kaplan-Meier analysis revealed that the high XOR group was at the highest risk for MACEs. Multivariate analysis by Cox's proportional hazard regression approach showed that high XOR activity was significantly associated with MACEs, after adjustment for confounding factors. The patients were also divided into four groups according to the absence/presence of high XOR activity and/or hyperuricaemia. According to the multivariate Cox regression analysis, high XOR activity was associated with MACEs, regardless of the hyperuricaemia status.

CONCLUSIONS:

Elevated plasma XOR activity is significantly associated with adverse clinical outcomes in patients with HFpEF.

• Authors: Ken Watanabe, Tetsu Watanabe, Yoichiro Otaki, Tetsuro Shishido, Takayo Murase, Takashi Nakamura, Shigehiko Kato, Harutoshi Tamura, Satoshi Nishiyama, Hiroki Takahashi, Takanori Arimoto, Masafumi Watanabe
• Journal: ESC heart failure (ESC Heart Fail) Vol. 7 Issue 4 Pg. 1735-1743 (08 2020) ISSN: 2055-5822 [Electronic] England
• PMID: 32432414 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Chemical References

• Uric Acid
• Xanthine Dehydrogenase

Topics

• Heart Failure
• Humans
• Hyperuricemia
• Stroke Volume
• Uric Acid
• Xanthine Dehydrogenase