Oxidative stress in patients with congenital heart disease: A systematic review

Congenital heart disease (CHD) represents a prevalent and diverse set of clinical conditions with significant morbidity and mortality. A recent meta-analysis indicates elevated oxidative stress levels in CHD patients compared to healthy controls. This review aims to elucidate the precise role of oxidative stress and its contributors in CHD. A systematic search of English-language publications on PubMed and the TRIP database yielded 29 reports analyzing oxidative stress markers in peripheral blood samples from pediatric and adult CHD populations. Only studies comparing oxidative stress markers either against controls, within CHD groups, or assessing oxidative stress markers over time evaluating the effect of an antioxidant treatment were included, followed by bias risk assessment. The different markers assessing oxidative stress in CHD were summarized, with scrutiny on potential influencing factors. Although findings are inconclusive overall, factors like cyanosis, genetic predispositions, and metabolic status emerge as important contributors. Additionally, multiple studies suggest a correlation between oxidative stress and CHD severity. Notably, no antioxidant therapies have been evaluated for reducing oxidative stress in CHD patients to date. Further research is imperative for a comprehensive understanding of CHD pathophysiology, particularly the heightened vulnerability of the right ventricle (RV) to heart failure (HF). Such insights could facilitate the development of tailored therapies for RV-related HF and dedicated antioxidant treatments, crucial for enhancing survival rates in this patient population.