M. Gorenflo et al., Plasma levels of asymmetrical dimethyl-L-arginine in patients with congenital heart disease and pulmonary hypertension, J CARDIO PH, 37(4), 2001, pp. 489-492
Citations number
10
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Asymmetrical dimethyl-L-arginine (ADMA) is an endogenous inhibitor of nitri
c oxide synthase. We hypothesized that plasma levels of ADMA could be incre
ased in patients with congenital heart disease and pulmonary hypertension.
Cardiac catheterization was performed in 20 children and young adults with
congenital heart disease with a median age of 10 years (range, 4 months to
33 years). The patients were assigned to group I (high flow, low pressure;
n = 14) when Qp/Qs was 1.5 or greater and the mean PAP was less than 25 mm
Hg or to group II (high pressure, high resistance; n = 6) when the mean PAP
was greater than 25 mm HE and Rp/Rs was greater than 0.3. Blood samples we
re taken from pulmonary vein or left ventricle. ADMA was measured by high-p
erformance liquid chromatography. In addition, levels of ADMA were measured
in peripheral venous blood obtained from eight control patients. Levels of
ADMA in control patients (median, 0.21 muM/l; range, 0.08-0.27 muM/l) did
not differ from levels obtained in group I (median, 0.30 muM/l; range, 0.06
-0.49) muM/l). Patients in group II showed increased plasma levels of ADMA
(median, 0.55; range, 0.25-0.79) (p < 0.01). Inhibition of nitric oxide syn
thase by increased levels of ADMA might contribute to pulmonary hypertensio
n in patients with congenital heart disease.