Serum oxidizability potential is associated with age and exercise test results

The purpose of this paper is to find out whether serum oxidizability potential measured before an exercise test (EXT) correlates with age and ischemic heart disease severity. Oxidizability potential was determined in 3 age groups, in gr. I patients < 45 years, in gr. II age range = 45 - 70years {\hbox{range}} = {45} - {7}0{\hbox{years}} , and in gr. III patients > 70 years. Included subjects had chronic ischemic heart disease (IHD) and underwent a symptom-limited EXT upon initiation of a cardiac rehabilitation program. The thermo-chemiluminescence (TCL) assay was used to assess serum oxidizability potential. This assay is based on heat-induced oxidation of serum, leading to the formation of electronically excited species in the form of unstable carbonyls, which further decompose into stable carbonyls and light energy (low chemiluminescence). Measured photons emission is represented by a kinetic curve which is described by its amplitude and slope (=ratio). We assessed the correlations of TCL ratio with age, exercise duration, metabolic equivalents (METS), maximal heart rate (mHR), maximal systolic BP, >1 mm S-T depression, diabetes, hypertension, smoking, left ventricular ejection fraction (LVEF)> or <40%, previous myocardial infarction, and aorto-coronary bypass surgery. A high TCL ratio (%) correlated well with METS (r = 0.82), mHR (r = 0.77) and with exercise-induced S-T segment shift (r = 0.86, p < 0.05). A lower serum oxidizability potential, expressed as a low TCL ratio, thus suggestive of a previous high oxidative stress, was found in the two older age groups compared to gr. I (<45 years), p = 0.041, and in particular, in gr. III patients with low LVEF%. The TCL ratio (%) in gr. III was 188.7 ± 14.5, 192 ± 17 in gr. II, and 214 ± 13 in gr. I (p < 0.05), and was 166 ± 13.1 in gr. III with LVEF < 45% as compared to 271 ± 15.7 in gr. I patients with LVEF > 45% (p < 0.01). A trend for lower TCL ratio (%) was found in diabetic, hypertensive, and post-coronary bypass surgery patients. A paradoxically low TCL ratio (low oxidizability potential) was observed in patients without S-T depression compared to patients with S-T depression (189 ± 22 vs. 201 ± 15, p = NS), due to the fact these patients had a much lower LVEF% and a lower exercise capacity. Serum oxidizability potential is associated with age, EXT parameters, results, and IHD severity. TCL ratio is an “easy-to-measure marker” that might be incorporated into risk assessment and prediction in aged IHD patients.