INTRODUCCIÓN: REVISIÓN CRITICA DEL PROBLEMA

Introduction
RESULTADOS
Advanced glycation end products (AGEs) are molecules that appear in plasma
and tissues and are generated by nonenzymatic glycation and oxidation of
proteins because of the Maillard reaction, which is driven by oxidative stress in its
final step 72 . In the setting of chronic heart failure (CHF), excess free-radical
generation leads to increased plasma levels of AGEs 268 . There is accumulating
evidence that an interaction of AGEs with their receptor (RAGE) causes activation
of intracellular signaling 269 , gene expression, and production of proinflammatory
cytokines and free radicals, thus playing a central role in the pathogenesis of
vascular and heart complications 270 . Biological function of the soluble form of
RAGE (sRAGE) has not been clearly defined and its biological importance within
the AGE-RAGE axis is only recently beginning to be understood 271,272 .
In the present study, we sought to evaluate the relation of sRAGE to severity and
prognosis of CHF and to analyze whether this parameter has an additional value
in predicting outcomes compared to the widely accepted Seattle Heart Failure
Score (SHFS) 267 . SHFS is a model used to predict CHF prognosis in outpatients
that uses common CHF clinical risk predictors and incorporates the effects of
medical therapy and device interventions. However, the model does not
incorporate certain HF prognostic parameters such as renal function 273 , B-type
natriuretic peptide levels (BNP) 274 , and other biomarkers.
Methods
a) Study population
One hundred six consecutive outpatients with stable CHF who visited our hospital
(cardiology department of University Hospital of Santiago de Compostela) from
September 008 through March 2009 were entered in this prospective study.
Causes of CHF were identified as hypertensive in 34%, ischemic in 33%, valvular
in 9%, and other in 24%. Diagnosis of CHF was based on clinic symptoms and
signs and evidence of structural and/or functional cardiac abnormalities (according
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