Congestive Heart Failure Clinical Trial
Official title:
The Effect of Left Ventricular Filling Pressure on Pulmonary Clearance of Free Radical Loaded White Blood Cells and Platelets in Congestive Heart Failure Patients Before and After Biventricular Pacing
1. To assess whether a correlation exist between the degree of pulmonary clearance of free
radical positive white bloodcells and platelets and the degree of pulmonary congestion
in congestive heart failure (CHF) patients
2. To asses whether cardiac resynchronization therapy improves pulmonary clearance of free
radical positive white blood cells and platelets in CHF patients by alleviating
pulmonary congestion
3. Interaction of oxidative stress with circulating endothelial progenitor cells (EPCs)
and presence of apoptotic endothelial (progenitor) cells
Evidence exists that oxidative stress is enhanced in congestive heart failure patients
resulting in damage to cellular lipids, proteins and DNA. Because of free radical-induced
apoptosis of skeletal muscle fibers, oxidative stress is an important contributor to
skeletal muscle fatigue and low exercise tolerance of congestive heart failure patients.
Enhanced oxidative stress in congestive heart failure can exert negative inotropic effects
and can have important effects on the structure and function of the myocardium, and may be
implicated in the progression of congestive heart failure. Free radical stress could also
impair recruitment and differentiation of circulating endothelial progenitor cells resulting
in increased all cause mortality.
Reduced pulmonary clearance of free radical loaded white blood cells and platelets is an
important contributor to enhanced oxidative stress in congestive heart failure patients.
Failure of pulmonary clearance of free radical loaded white blood cells and platelets
probably results from pulmonary congestion which has led to the rationale of the current
study. Biventricular pacing for resynchronization therapy in congestive heart failure
patients reduces left ventricular filling pressure and pulmonary congestion. Biventricular
pacing may therefore augment pulmonary clearance of free radical loaded white blood cells
and platelets in congestive heart failure patients.
We conduct a prospective, observational clinical study to investigate the correlation of
left ventricular filling pressure, pulmonary clearance of FR loaded circulating white blood
cells and platelets and number of endothelial progenitor cells in congestive heart failure
(CHF) patients before and after implantation of a biventricular pacemaker for
resynchronization therapy.
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