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Background—It has been suggested that oxidant stress may play a role in the pathophysiology of heart failure. However, no definitive information is available because most previous approaches used to measure oxidant stress are nonspecific, inaccurate, and unreliable.

Methods and Results—To evaluate oxidant stress in the heart, we measured pericardial fluid levels of 8-iso-prostaglandin F_2α (8-iso-PGF_2α), a specific and quantitative marker of oxidant stress in vivo, in a series of 51 consecutive patients with ischemic and/or valvular heart disease referred for cardiac surgery. Pericardial levels of 8-iso-PGF_2α were correlated with the functional severity of heart failure (NYHA classification) and with echocardiographic indices of ventricular dilatation measured by independent physicians. Pericardial levels of 8-iso-PGF_2α were significantly increased in patients with symptomatic heart failure compared with …