Prognostic importance of the oxidized product of catecholamines, adrenolutin, in patients with severe heart failure

Jean L. Rouleau, B. Pitt, N. S. Dhalla, K. S. Dhalla, K. Swedberg, M. S. Hansen, E. Stanton, N. Lapointe, M. Packer

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives: The purpose of this study was to assess whether adrenolutin, the inert product of the highly reactive molecules aminochromes, is increased in severe chronic heart failure and whether it is associated with a poor prognosis. Background: Experimental evidence suggests that oxidative products of catecholamines, aminochromes, are more cardiotoxic than unoxidized catecholamines and may be increased in heart failure. Methods: Adrenolutin was measured at baseline and at 1 and 3 months in 263 patients with chronic New York Heart Association class III or IV heart failure and a left ventricular ejection fraction of 22% ± 7%. Adrenolutin levels were compared with normal levels, and their relation to prognosis was evaluated. Results: Baseline adrenolutin was increased (55 ± 90 pg/mL vs 8.4 ± 9.1 pg/mL for control, P < .02) and remained increased at 1 month (49 ± 65 pg/mL). During a mean follow-up of 309 ± 148 days (22-609 days), 57 patients died. Baseline adrenolutin levels correlated with mortality rates by univariate and multivariate analyses (relative risk 1.06, 95% CI 1.01-1.10 for each 17.9-pg/mL rise, P = .032). Left ventricular ejection fraction (P = .013) and New York Heart Association class (P = .009) were the only other variables associated with survival. Age, sex, plasma creatinine, plasma N-terminal atrial natriuretic peptide, and plasma norepinephrine levels were not retained in our model. Adrenolutin levels 1 month after random assignment were not significantly correlated with total mortality rate (P = .061) but were correlated with mortality rate from low output (relative risk 1.14, 95% CI 1.06-1.22, P = .002). Conclusions: Plasma adrenolutin is increased in patients with heart failure and correlates with a poor prognosis independent of other important predictors of survival. This finding has potentially important pathophysiologic, prognostic, and therapeutic implications.

Original languageEnglish (US)
Pages (from-to)926-932
Number of pages7
JournalAmerican Heart Journal
Volume145
Issue number5
DOIs
StatePublished - May 1 2003

Fingerprint

Catecholamines
Heart Failure
Stroke Volume
Mortality
Survival
Atrial Natriuretic Factor
adrenolutin
Creatinine
Norepinephrine
Multivariate Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Rouleau, J. L., Pitt, B., Dhalla, N. S., Dhalla, K. S., Swedberg, K., Hansen, M. S., ... Packer, M. (2003). Prognostic importance of the oxidized product of catecholamines, adrenolutin, in patients with severe heart failure. American Heart Journal, 145(5), 926-932. https://doi.org/10.1016/S0002-8703(02)94782-4

Prognostic importance of the oxidized product of catecholamines, adrenolutin, in patients with severe heart failure. / Rouleau, Jean L.; Pitt, B.; Dhalla, N. S.; Dhalla, K. S.; Swedberg, K.; Hansen, M. S.; Stanton, E.; Lapointe, N.; Packer, M.

In: American Heart Journal, Vol. 145, No. 5, 01.05.2003, p. 926-932.

Research output: Contribution to journalArticle

Rouleau, JL, Pitt, B, Dhalla, NS, Dhalla, KS, Swedberg, K, Hansen, MS, Stanton, E, Lapointe, N & Packer, M 2003, 'Prognostic importance of the oxidized product of catecholamines, adrenolutin, in patients with severe heart failure', American Heart Journal, vol. 145, no. 5, pp. 926-932. https://doi.org/10.1016/S0002-8703(02)94782-4
Rouleau, Jean L. ; Pitt, B. ; Dhalla, N. S. ; Dhalla, K. S. ; Swedberg, K. ; Hansen, M. S. ; Stanton, E. ; Lapointe, N. ; Packer, M. / Prognostic importance of the oxidized product of catecholamines, adrenolutin, in patients with severe heart failure. In: American Heart Journal. 2003 ; Vol. 145, No. 5. pp. 926-932.
@article{daf28a7050fa457d9b27f400680da93e,
title = "Prognostic importance of the oxidized product of catecholamines, adrenolutin, in patients with severe heart failure",
abstract = "Objectives: The purpose of this study was to assess whether adrenolutin, the inert product of the highly reactive molecules aminochromes, is increased in severe chronic heart failure and whether it is associated with a poor prognosis. Background: Experimental evidence suggests that oxidative products of catecholamines, aminochromes, are more cardiotoxic than unoxidized catecholamines and may be increased in heart failure. Methods: Adrenolutin was measured at baseline and at 1 and 3 months in 263 patients with chronic New York Heart Association class III or IV heart failure and a left ventricular ejection fraction of 22{\%} ± 7{\%}. Adrenolutin levels were compared with normal levels, and their relation to prognosis was evaluated. Results: Baseline adrenolutin was increased (55 ± 90 pg/mL vs 8.4 ± 9.1 pg/mL for control, P < .02) and remained increased at 1 month (49 ± 65 pg/mL). During a mean follow-up of 309 ± 148 days (22-609 days), 57 patients died. Baseline adrenolutin levels correlated with mortality rates by univariate and multivariate analyses (relative risk 1.06, 95{\%} CI 1.01-1.10 for each 17.9-pg/mL rise, P = .032). Left ventricular ejection fraction (P = .013) and New York Heart Association class (P = .009) were the only other variables associated with survival. Age, sex, plasma creatinine, plasma N-terminal atrial natriuretic peptide, and plasma norepinephrine levels were not retained in our model. Adrenolutin levels 1 month after random assignment were not significantly correlated with total mortality rate (P = .061) but were correlated with mortality rate from low output (relative risk 1.14, 95{\%} CI 1.06-1.22, P = .002). Conclusions: Plasma adrenolutin is increased in patients with heart failure and correlates with a poor prognosis independent of other important predictors of survival. This finding has potentially important pathophysiologic, prognostic, and therapeutic implications.",
author = "Rouleau, {Jean L.} and B. Pitt and Dhalla, {N. S.} and Dhalla, {K. S.} and K. Swedberg and Hansen, {M. S.} and E. Stanton and N. Lapointe and M. Packer",
year = "2003",
month = "5",
day = "1",
doi = "10.1016/S0002-8703(02)94782-4",
language = "English (US)",
volume = "145",
pages = "926--932",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Prognostic importance of the oxidized product of catecholamines, adrenolutin, in patients with severe heart failure

AU - Rouleau, Jean L.

AU - Pitt, B.

AU - Dhalla, N. S.

AU - Dhalla, K. S.

AU - Swedberg, K.

AU - Hansen, M. S.

AU - Stanton, E.

AU - Lapointe, N.

AU - Packer, M.

PY - 2003/5/1

Y1 - 2003/5/1

N2 - Objectives: The purpose of this study was to assess whether adrenolutin, the inert product of the highly reactive molecules aminochromes, is increased in severe chronic heart failure and whether it is associated with a poor prognosis. Background: Experimental evidence suggests that oxidative products of catecholamines, aminochromes, are more cardiotoxic than unoxidized catecholamines and may be increased in heart failure. Methods: Adrenolutin was measured at baseline and at 1 and 3 months in 263 patients with chronic New York Heart Association class III or IV heart failure and a left ventricular ejection fraction of 22% ± 7%. Adrenolutin levels were compared with normal levels, and their relation to prognosis was evaluated. Results: Baseline adrenolutin was increased (55 ± 90 pg/mL vs 8.4 ± 9.1 pg/mL for control, P < .02) and remained increased at 1 month (49 ± 65 pg/mL). During a mean follow-up of 309 ± 148 days (22-609 days), 57 patients died. Baseline adrenolutin levels correlated with mortality rates by univariate and multivariate analyses (relative risk 1.06, 95% CI 1.01-1.10 for each 17.9-pg/mL rise, P = .032). Left ventricular ejection fraction (P = .013) and New York Heart Association class (P = .009) were the only other variables associated with survival. Age, sex, plasma creatinine, plasma N-terminal atrial natriuretic peptide, and plasma norepinephrine levels were not retained in our model. Adrenolutin levels 1 month after random assignment were not significantly correlated with total mortality rate (P = .061) but were correlated with mortality rate from low output (relative risk 1.14, 95% CI 1.06-1.22, P = .002). Conclusions: Plasma adrenolutin is increased in patients with heart failure and correlates with a poor prognosis independent of other important predictors of survival. This finding has potentially important pathophysiologic, prognostic, and therapeutic implications.

AB - Objectives: The purpose of this study was to assess whether adrenolutin, the inert product of the highly reactive molecules aminochromes, is increased in severe chronic heart failure and whether it is associated with a poor prognosis. Background: Experimental evidence suggests that oxidative products of catecholamines, aminochromes, are more cardiotoxic than unoxidized catecholamines and may be increased in heart failure. Methods: Adrenolutin was measured at baseline and at 1 and 3 months in 263 patients with chronic New York Heart Association class III or IV heart failure and a left ventricular ejection fraction of 22% ± 7%. Adrenolutin levels were compared with normal levels, and their relation to prognosis was evaluated. Results: Baseline adrenolutin was increased (55 ± 90 pg/mL vs 8.4 ± 9.1 pg/mL for control, P < .02) and remained increased at 1 month (49 ± 65 pg/mL). During a mean follow-up of 309 ± 148 days (22-609 days), 57 patients died. Baseline adrenolutin levels correlated with mortality rates by univariate and multivariate analyses (relative risk 1.06, 95% CI 1.01-1.10 for each 17.9-pg/mL rise, P = .032). Left ventricular ejection fraction (P = .013) and New York Heart Association class (P = .009) were the only other variables associated with survival. Age, sex, plasma creatinine, plasma N-terminal atrial natriuretic peptide, and plasma norepinephrine levels were not retained in our model. Adrenolutin levels 1 month after random assignment were not significantly correlated with total mortality rate (P = .061) but were correlated with mortality rate from low output (relative risk 1.14, 95% CI 1.06-1.22, P = .002). Conclusions: Plasma adrenolutin is increased in patients with heart failure and correlates with a poor prognosis independent of other important predictors of survival. This finding has potentially important pathophysiologic, prognostic, and therapeutic implications.

UR - http://www.scopus.com/inward/record.url?scp=0038065613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038065613&partnerID=8YFLogxK

U2 - 10.1016/S0002-8703(02)94782-4

DO - 10.1016/S0002-8703(02)94782-4

M3 - Article

C2 - 12766756

AN - SCOPUS:0038065613

VL - 145

SP - 926

EP - 932

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 5

ER -