Associations of Methylarginines and Homoarginine With Diastolic Dysfunction and Cardiovascular Risk Factors in Patients With Preserved Left Ventricular Ejection Fraction |
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| Institution: | 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria;2. Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands;3. Department of Cardiology and Pneumology, University of Goettingen, Goettingen, Germany;4. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria;5. Coordination Center for Clinical Trials, University of Leipzig, Leipzig, Germany;6. Department of Cardiology, Charité-Universitätsmedizin Berlin, Germany;7. Department of Cardiology, Medical University of Graz, Austria;8. Brahms, Hennigsdorf, Germany;9. Synlab Center of Laboratory Diagnostics, Heidelberg, Germany;10. Mannheim Institute of Public Health, Medical Faculty Mannheim, Ruperto Carola University Heidelberg, Mannheim, Germany;1. Advanced Heart Failure and Transplantation Center, Department of Cardiology, University Medical Center, Ljubljana, Slovenia;2. Department of Intensive Care Medicine, University Medical Center, Ljubljana, Slovenia;3. Institute of Physiology, University of Ljubljana School of Medicine, Ljubljana, Slovenia;4. Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California;1. Division of Cardiology, Department of Internal Medicine III, Innsbruck University Medical School, Innsbruck, Austria;2. Department of Anesthesiology, Innsbruck University Medical School, Innsbruck, Austria;3. Department of Medical Statistics, Informatics and Health Economics, Innsbruck University Medical School, Innsbruck, Austria;4. Department of Cardiac Surgery, Innsbruck University Medical School, Innsbruck, Austria;5. Department of Radiology II, Innsbruck University Medical School, Innsbruck, Austria;6. Department of Cardiology, Department of Cardiovascular Medicine, Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates;1. Department of Medicine, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, Florida;2. Department of Medicine, Division of Cardiovascular Medicine, University of Southern California, Los Angeles, California;1. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;2. Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland;3. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland;1. Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio;2. Department of Mathematics, Cleveland State University, Cleveland, Ohio;3. Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio |
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| Abstract: | BackgroundAsymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and homoarginine are considered to modulate nitric oxide synthesis. We evaluated whether ADMA, SDMA, and homoarginine are associated with diastolic dysfunction.Methods and ResultsWe investigated primary care patients at cardiovascular risk with preserved left ventricular ejection fraction from the multicenter DIAST-CHF study. We measured serum concentrations of ADMA, SDMA, and homoarginine and performed standardized echocardiographic examinations. Among 1,396 patients (mean age 65.3 ± 8.3 y, 54.6% women), diastolic dysfunction was ruled out in 261 patients (18.7%). Mild and moderate/severe grades of diastolic dysfunction were present in 900 (64.5%) and 235 (16.8%) study participants, respectively. After adjustments for cardiovascular risk factors, ADMA and SDMA were positively and homoarginine negatively associated with N-terminal pro–B-type natriuretic peptide and midregional pro-adrenomedullin (P < .05 for all). Lower homoarginine levels were associated with diastolic dysfunction, and higher ADMA and SDMA levels were associated with the severity of diastolic dysfunction (P < .05 for all).ConclusionsHigher levels of ADMA and SDMA and lower levels of homoarginine are associated with an adverse cardiovascular risk profile and diastolic dysfunction. Further studies should clarify the potential of these amino acid derivatives for the therapy of cardiovascular diseases. |
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| Keywords: | Homoarginine methylarginines diastolic dysfunction cardiovascular risk |
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