The Association Between Oxidative Stress and the Progression of Heart Failure: A Systematic Review

Chronic heart failure (CHF) is a progressive multifactorial condition where the role of oxidative stress may have implications in the pathogenesis of the disease. Despite growing interest among researchers and clinicians, the limited, unorganized, and divergent findings regarding the association between oxidative stress and the progression of heart failure (HF) have prompted us to conduct this study. Drawing upon the evolving nature of this research domain, this study is one of the first of its kind to present a systematic and comprehensive overview of the existing evidence regarding the role of oxidative stress production in the progression of HF. This study systematically reviews peer-reviewed empirical studies published in English, particularly focusing on the association between oxidative stress and the progression of HF. Parameters, such as publication year, study design, population demographics (size, age, and gender), types of HF, and characterization of markers in the existing studies, were reviewed. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedure, a thorough search was conducted on PubMed, Cochrane, Embase, and Sage databases, without any restrictions on the publication dates of articles, which yielded a total of 1,808 records on the association of oxidative stress production with clinical outcomes in HF patients. The analysis of the content of 17 articles offered a robust observation of this phenomenon, providing insights into the levels of oxidative stress, antioxidant markers, and the enzymes involved in the production of reactive oxygen species (ROS), and their association with the progression and severity of HF. The findings highlighted various knowledge gaps and future research priorities are recommended in the areas of interest and unexplored areas.