TREATMENT WITH L-ARGININE IS LIKELY TO STIMULATE GENERATION OF NITRIC-OXIDE IN PATIENTS WITH PERIPHERAL ARTERIAL OBSTRUCTIVE DISEASE

The impairment of endothelial function in hypercholesterolaemic animal s and humans is known to be reversed by intravenous infusions of L-arg inine (L-ARG), the precursor of NO. 22 patients with peripheral arteri al obstructive disease (PAOD) received L-ARG (60 mmol) as intravenous infusions, each lasting three hours, daily for seven consecutive days. This treatment resulted in elongation of the pain-free and maximum wa lking distances, as well as shortening of the period of time required for pain relief after walking the maximum distance. A rise in the ankl e/arm pressure ratio (AAPR) was associated with an increase of arteria l blood flow in both calves. The transcutaneous oxygen tension (tcpO(2 )) in the ischaemic foot was also increased. After the Ist and the 7th infusion of L-ARG the spontaneous (PAR) as well as the ADP- and colla gen-induced platelet aggregation were suppressed, the euglobulin clot lysis time (ECLT) shortened, plasma levels of platelet activator inhib itor (PAI) decreased. and cGMP levels increased. These data indicate b eneficial effects of L-ARG as a therapeutic agent in patients with PAO D. We presume that in these patients high doses of exogenous L-ARG can be partially converted to NO.