Clin Chem Lab Med 2008;46(3):382–386  2008 by Walter de Gruyter • Berlin • New York. DOI 10.1515/CCLM.2008.061 2007/256 Article in press - uncorrected proof Coenzyme Q10 and high-sensitivity C-reactive protein in ischemic and idiopathic dilated cardiomyopathy Mehmet Senes 1, *, Ali Rıza Erbay 2 , F. Meric ¸ ¸ ¸ Yılmaz 1 , B. Cig ˘ dem Topkaya 1 , Og ˘ uzhan Zengi 1 , ¸ Mehmet Dog ˘ an 2 and Dog ˘ an Yu ¨ cel 1 1 Department of Clinical Biochemistry, Ankara Education and Research Hospital, Ankara, Turkey 2 Department of Cardiology, High Specialization Hospital, Ankara, Turkey Abstract Background: Cardiomyopathy (CMP) is a common debilitating illness, associated with a high mortality and poor quality of life. There is extensive evidence from in vitro and animal experiments that CMP is a state of increased oxidative stress. Coenzyme Q10 (CoQ10) and high-sensitivity C-reactive protein (hs- CRP) are important markers to evaluate the oxidative stress and inflammatory status of patients with CMP. Methods: A total of 28 patients with chronic stable heart failure (21 men and 7 women, ages 18–76 years) were included in the study. Causes of heart failure were ischemic CMP in 17 patients and idiopathic dilat- ed CMP in 11 patients. A total of 28 patients (12 men and 16 women; ages 30–71 years) with normal coro- nary angiography were enrolled as a control group. Levels of CoQ10, albumin, total thiol groups (T-SH), bilirubin, uric acid as plasma antioxidants, hs-CRP as an inflammation marker and lipid profile were studied in patients and controls. Results: Plasma CoQ10, T-SH and albumin levels were significantly decreased in patients compared to controls. Uric acid, bilirubin and hs-CRP levels were found to be significantly increased compared to controls. Conclusions: In this study, evidence of decreased anti- oxidant status was determined in CMP patients together with vascular inflammation. CoQ10, other plasma antioxidants and hs-CRP measured routinely can reflect decreased antioxidant status and inflam- matory process in patients with dilated CMP. These markers can be used to monitor the status of patients with CMP. Clin Chem Lab Med 2008;46:382–6. Keywords: antioxidants; cardiomyopathy; coenzyme Q10; C-reactive protein; heart failure; oxidative stress. *Corresponding author: Mehmet Senes, S.B. Ankara Eg ˘ itim ¸ ¸ ve Arastırma Hastanesi, Ulucanlar Cad., Cebeci, ¸ Ankara 06340, Turkey Phone: q90-312-5953212, Fax: q90-312-3621857, E-mail: senesmehmet@yahoo.com Received June 1, 2007; accepted November 15, 2007; previously published online February 6, 2008 Introduction Heart failure is a major healthcare problem, and despite significant therapeutic advances, morbidity and mortality in heart failure still remain high. Patients with cardiomyopathy (CMP) constitute an important part of heart failure patients. CMP is a dis- ease of various etiology characterized by low ejection fraction, left ventricular enlargement or hypertrophy, and symptoms of congestive heart failure. The most common forms are ischemic and dilated CMPs. Ventricular arrhythmias, thromboembolic phenome- na and sudden death are common in patients with these forms. Therefore, novel insights into pathophy- siology and mechanisms of CMP are required to develop novel therapeutic approaches. Increased reactive oxygen species (ROS) genera- tion may play an important role in this state. In fact, some studies indicate increased ROS generation in patients with congestive heart failure (CHF) (1–4). ROS are removed or neutralized by an antioxidant defense system (5). An imbalance between ROS and antioxidant defenses in favor of the former has been described as oxidative stress (6). In general, decreased plasma antioxidants may reflect the status of oxidative stress, because they are depleted by ROS. Additionally, oxidative stress and heart failure are associated with inflammation. In addition to the myocardium itself, several tissues and cells can contribute to this inflammation, including leukocytes, platelets, tissue macrophages and endothelial cells (7). Activation of the immune system may also play a role in the pathogenesis of heart failure (8). Plasma contains a variety of antioxidant constitu- ents with redox activity and many of these constitu- ents have been ascribed primary antioxidant roles. Important plasma antioxidants appear to be ascorbic acid, uric acid, a-tocopherol, albumin-bound bilirubin, albumin itself and protein sulfhydryl groups (9). Coen- zyme Q10 (CoQ10), the predominant form of ubiqui- none in man, is also a redox activity antioxidant radical scavenger molecule and is carried mainly by lipoproteins in circulation (10, 11). CoQ10 acts togeth- er with vitamin E and serves to regenerate the active a-tocopherol form of the vitamin (12). Moreover, CoQ10-dependent electron transport across the plas- ma membrane can be used to regenerate ascorbate outside the cell from ascorbate radical (10). In view of these considerations, our aim was to investigate the levels of some plasma antioxidants, such as CoQ10 (the predominant form of ubiquinone in man), albumin and total thiol groups (T-SH) in patients with ischemic and idiopathic dilated CMP. In addition to these antioxidants, we measured the levels of serum high-sensitivity C-reactive protein Brought to you by | University of Georgia Libraries Authenticated Download Date | 5/26/15 10:23 AM