BACKGROUND AND PURPOSE: Endothelial dysfunction may play a causal role in cerebral small vessel disease (SVD). Asymmetric dimethylarginine (ADMA), a circulating endogenous inhibitor of nitric oxide, has been implicated in endothelial dysfunction, particularly in hyperhomocystinemia, a known risk factor for SVD. We determined if ADMA was elevated in SVD, correlated with disease severity, and interacted with homocysteine. METHODS: ADMA and homocysteine levels were determined in 47 consecutive symptomatic SVD patients and 38 controls. SVD was graded by leukoariosis severity and number of lacunar infarcts. RESULTS: Mean (and SD) ADMA was higher in SVD patients compared with controls (0.814 [0.145] versus 0.747 [0.184] micromol/L; P=0.014) after controlling for age, gender, vascular risk factors, and creatinine clearance. Additionally controlling for homocysteine had only a small effect on this relationship (P=0.055). Mean homocysteine was higher in SVD cases compared with controls (15.14 [5.59] versus 12.49 [4.15] micromol/L; P=0.035). Leukoariosis grade correlated positively with ADMA (P=0.026) and homocysteine (P=0.003). Lacunar grade correlated with homocysteine (P=0.017), but not ADMA. CONCLUSIONS: ADMA is independently associated with SVD and correlates with leukoariosis severity.
BACKGROUND AND PURPOSE: Endothelial dysfunction may play a causal role in cerebral small vessel disease (SVD). Asymmetric dimethylarginine (ADMA), a circulating endogenous inhibitor of nitric oxide, has been implicated in endothelial dysfunction, particularly in hyperhomocystinemia, a known risk factor for SVD. We determined if ADMA was elevated in SVD, correlated with disease severity, and interacted with homocysteine. METHODS:ADMA and homocysteine levels were determined in 47 consecutive symptomatic SVDpatients and 38 controls. SVD was graded by leukoariosis severity and number of lacunar infarcts. RESULTS: Mean (and SD) ADMA was higher in SVDpatients compared with controls (0.814 [0.145] versus 0.747 [0.184] micromol/L; P=0.014) after controlling for age, gender, vascular risk factors, and creatinine clearance. Additionally controlling for homocysteine had only a small effect on this relationship (P=0.055). Mean homocysteine was higher in SVD cases compared with controls (15.14 [5.59] versus 12.49 [4.15] micromol/L; P=0.035). Leukoariosis grade correlated positively with ADMA (P=0.026) and homocysteine (P=0.003). Lacunar grade correlated with homocysteine (P=0.017), but not ADMA. CONCLUSIONS:ADMA is independently associated with SVD and correlates with leukoariosis severity.
Authors: A Vilar-Bergua; I Riba-Llena; C Nafría; A Bustamante; V Llombart; P Delgado; J Montaner Journal: J Cereb Blood Flow Metab Date: 2016-01 Impact factor: 6.200
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