Oxidative / Nitrosative Stress ss in Chronic Heart Failure: A Critical Review

Heart failure constitutes a major cardiovascular health hazard worldwide. It afflicts over 1% of the general population and nearly 1 in 10 of the elderly. Chronic heart failure (CHF) also accounts for an increasing proportion of available hospital resources. Moreover, despite intense medical care, the outlook ok for the patient with chronic heart failure continues to remain quite dismal; both quality of life and survival prospects are severely limited. Ventricular arrhythmias, thromboembolic phenomena and sudden death are common in patients with this syndrome. There is extensive experimental evidence from in vitro and animal experimentsthat chronic heart failu lure is a state of increased oxidative and nitrosative stress. Moreover, in animal models, the development of CHF is accompanied by changes in the antioxidant defense mechanisms of the myocardium as well as evidence of oxidative myocardial inju jury. On the other hand, in general, increased nitrosativestress is linked to increased oxidative stress. Alterations in nitric oxide synthase NOS) activity and nitric oxide ( NO) may contribute to failing heart. These data have led to the hypothesis that increased oxidative and nitrosative stress at least maybe a mechanism of disease progression in CHF. In this article, studies on oxidative/nitrosative stress in CHF are reviewed with all dimensions.