Increased renal formation of thromboxane A(2) and prostaglandin F-2 alpha in heart failure

Renal formation of the vasoconstrictor prostaglandins thromboxane A(2) (TXA(2)) and prostaglandin F-2 alpha (PGF(2 alpha)) was investigated in 25 patients with cardiac failure, divided into New York Heart Association functional classes I to IV, and in eight healthy control subjects. Plasma renin activity (PRA) and hemodynamic parameters were also investigated. Renal vasoconstrictor eicosanoid formation, measured in urinary daily excretion, was not different between patients in class I and control subjects. Class II to IV patients showed progressively increasing production of PGF(2 alpha) (F = 49.8, p < 0.001, analysis of variance) and TXA(2) (F = 37.8, p < 0.002). PGF(2 alpha) excretion peaked in class IV (+1266% vs class I, p < 0.001). Compared with class I, urinary excretion of thromboxane B-2 was +816% in class III and +1561% in class IV (both p < 0.001). PRA was significantly increased only in class IV (+1558%, p < 0.001). The current results indicate a progressive increase in renal production of vasoconstrictor eicosanoids directly related to New York Heart Association class and suggest that these prostanoids may have a role in deterioration of renal function.