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Assessment of asymmetric dimethylarginine in patients with pulmonary hypertension

А.В. Казымлы, Н.С. Гончарова, А.В. Березина, А.В. Наймушин, О.М. Моисеева

Authors: A.V. Kazimli, N.S. Goncharova, A.V. Berezina, A.V. Naymushin, O.M. Moiseeva

Place: St Petersburg, Russia

Institution: Federal Almazov Medical Research Centre

Abstract:

Objective. Asymmetrical dimethylarginine (ADMA) is an endogenous nitric oxide inhibitor. Increased level ADMA may contribute to endothelial dysfunction in patients with pulmonary hypertension (PH). The aim of the study was to assess the possible link between ADMA and basic determinants of PH severity. Design and methods. We examined 56 patients with PH (mean age 42,8 ± 14,5 years, 19 males): idiopathic pulmonary arterial hypertension was diagnosed in 32 subjects, 7 subjects had corrected congenital heart disease, 7 subjects had scleroderma, and 11 — inoperable chronic thromboembolic pulmonary hypertension, and 12 healthy subjects formed control group (41,8 ± 10,3 years, 3 males). Serum ADMA by ELISA method, serum NT pro-BNP (Elecsys) and uric acid levels were determined. Echocardiography, 6-minute walking test (6MWT), right heart catheterization and cardiopulmonary exercise testing (CPX) were performed. Results. The symptoms of II functional class (FC) WHO were present in 23 % patients, III FC — in 59 % patients and IV FC — in 13 % patients, 6MWT was decreased (362 ± 97 m) and NT-proBNP level was elevated (1833 ± 2176 pg/ml). Serum ADMA level in patients with PH were elevated in comparison with healthy controls (0,68 ± 0,25 vs 0,35 ± 0,12 ^mol/l; p

Keywords: pulmonary hypertension, asymmetric dimethylarginine, prognostic marker, functional class

 

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