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Role of oxidative stress in heart failure

Michael M Givertz, MD
Section Editor
Wilson S Colucci, MD
Deputy Editor
Susan B Yeon, MD, JD, FACC


Oxidant byproducts, such as superoxide anion (O2-) and hydrogen peroxide, are produced in the body as a consequence of normal aerobic metabolism. These molecules are highly reactive with other biologic molecules, and are referred to as reactive oxygen species (ROS) [1]. Under normal physiologic conditions, the production of oxygen free radicals and peroxides is balanced by an efficient system of antioxidants, which are molecules capable of "scavenging" ROS, thereby preventing oxidative damage [2]. Naturally occurring antioxidants are of several types.

At the cellular level, enzymatic antioxidants, such as superoxide dismutase and catalase, play an important role in the conversion of ROS to oxygen and water.

Several nonenzymatic antioxidants are also important in scavenging free radicals. Included in this group are the lipid-soluble antioxidants alpha tocopherol (vitamin E) and beta-carotene, and the water-soluble antioxidants ascorbic acid (vitamin C) and glutathione. (See "Nutritional antioxidants in coronary heart disease".)

In pathologic states, free radicals may be present in relative excess. This shift of the balance in favor of oxidation, termed "oxidative stress," may have detrimental effects on cellular and tissue function, contributing to the pathogenesis of a wide variety of disease states, including HF, atherosclerosis, and cancer, and to the normal process of aging [3,4]. This topic will discuss the role of oxidative stress in HF [5,6].


A number of experimental observations have raised the possibility that oxidative stress may play a role in the development of myocardial failure.

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Literature review current through: Sep 2017. | This topic last updated: Jul 30, 2015.
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