BACKGROUND: Despite the frequent simultaneous presentation of cardiac and renal dysfunction, the relationship between these pathophysiological processes remains unclear. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO) synthase, which has been linked to endothelial dysfunction and atherosclerosis. This study elucidates the relationship between ADMA and intrarenal and coronary microvascular diseases. METHODS: In this study, we included 66 consecutive hypertensive patients with normal renal function or mild renal insufficiency (creatinine <or= 1.2 mg/dl). On the basis of their estimated glomerular filtration rate (eGFR), the patients were divided into two groups (normal group, eGFR >or=90 ml/min; renal insufficiency group, eGFR <90 ml/min). Coronary flow velocity reserve (CFVR) was measured using adenosine-triphosphate stress transthoracic Doppler echocardiography. In addition, a plasma ADMA assay, echocardiography, carotid ultrasound, and brachial-ankle pulse wave velocity measurement were performed. RESULTS: The plasma ADMA level was the highest in patients with both renal insufficiency and reduced CFVR. ADMA was significantly associated with eGFR (r = -0.342, P = 0.006) and CFVR (r = -0.459, P < 0.001), and eGFR and CFVR were significantly associated with each other (r = 0.337, P = 0.006). Multiple regression analysis revealed that ADMA was an independent clinical parameter associated with both eGFR and CFVR. CONCLUSIONS: Plasma ADMA is suggested to be an incipient biochemical marker of microvascular disease in both kidney and heart in hypertensive patients. ADMA might play an important role in the pathogenesis of organ damage in the kidney and heart in essential hypertension.
BACKGROUND: Despite the frequent simultaneous presentation of cardiac and renal dysfunction, the relationship between these pathophysiological processes remains unclear. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO) synthase, which has been linked to endothelial dysfunction and atherosclerosis. This study elucidates the relationship between ADMA and intrarenal and coronary microvascular diseases. METHODS: In this study, we included 66 consecutive hypertensivepatients with normal renal function or mild renal insufficiency (creatinine <or= 1.2 mg/dl). On the basis of their estimated glomerular filtration rate (eGFR), the patients were divided into two groups (normal group, eGFR >or=90 ml/min; renal insufficiency group, eGFR <90 ml/min). Coronary flow velocity reserve (CFVR) was measured using adenosine-triphosphate stress transthoracic Doppler echocardiography. In addition, a plasma ADMA assay, echocardiography, carotid ultrasound, and brachial-ankle pulse wave velocity measurement were performed. RESULTS: The plasma ADMA level was the highest in patients with both renal insufficiency and reduced CFVR. ADMA was significantly associated with eGFR (r = -0.342, P = 0.006) and CFVR (r = -0.459, P < 0.001), and eGFR and CFVR were significantly associated with each other (r = 0.337, P = 0.006). Multiple regression analysis revealed that ADMA was an independent clinical parameter associated with both eGFR and CFVR. CONCLUSIONS: Plasma ADMA is suggested to be an incipient biochemical marker of microvascular disease in both kidney and heart in hypertensivepatients. ADMA might play an important role in the pathogenesis of organ damage in the kidney and heart in essential hypertension.
Authors: Daniel S Feuer; Eileen M Handberg; Borna Mehrad; Janet Wei; C Noel Bairey Merz; Carl J Pepine; Ellen C Keeley Journal: Am J Med Date: 2022-04-23 Impact factor: 5.928
Authors: R Preston Mason; Robert F Jacob; J Jose Corbalan; Roman Kaliszan; Tadeusz Malinski Journal: Am J Hypertens Date: 2013-10-29 Impact factor: 2.689
Authors: Philip Düsing; Andreas Zietzer; Philip Roger Goody; Mohammed Rabiul Hosen; Christian Kurts; Georg Nickenig; Felix Jansen Journal: J Mol Med (Berl) Date: 2021-01-22 Impact factor: 4.599