Wei Xia1, Yan Wang1, Tongqing Duan2, Yuanyuan Rong3, Yifan Chi1, Yibing Shao4. 1. Department of Cardiology, Qingdao Municipal Hospital, Shandong Province, China. 2. Department of Ultrasonography, Qingdao Fuwai Cardiovascular Hospital, Shandong Province, China. 3. Department of Gerontology, Qingdao Municipal Hospital, Shandong Province, China. 4. Department of Cardiology, Qingdao Municipal Hospital, Shandong Province, China. Electronic address: summer0419163@163.com.
Abstract
INTRODUCTION: Atrial fibrillation (AF) is associated with increased thrombo-embolic events, with thrombi most frequently located in the left atrial appendage (LAA). Asymmetric dimethylarginine (ADMA), a potent endogenous inhibitor of nitric oxide synthase, is elevated in subjects with AF. We investigated the relationship between ADMA and risk of LAA thrombus in patients with non-valvular AF. METHODS AND RESULTS: A total of 223 consecutive patients with non-valvular AF were enrolled (63 ± 10 years, 65% male). LAA thrombus was detected in 27 subjects by transesophageal echocardiography. Serum ADMA was significantly increased (2.5 ± 0.6 μmol/L vs 1.8 ± 0.4 μmol/L, p<0.001), while serum nitrite/nitrate was significantly reduced in patients with LAA thrombus (30.3 ± 7.1 μmol/L vs 48.4 ± 9.3 μmol/L, p<0.001). ADMA was positively correlated with age and left atrium diameter, and was negatively correlated with nitrite/nitrate and LAA peak flow velocity. The area under the receiver operating characteristic curve of ADMA predicting thrombus was 0.84. In multivariate logistic regression analysis, ADMA (OR 4.0, 95% CI 1.2-13.0; p=0.003) was one of independent risk factors for LAA thrombus. CONCLUSIONS: Our study suggested that high ADMA was independently associated with the presence of LAA thrombus in patients with non-valvular AF.
INTRODUCTION:Atrial fibrillation (AF) is associated with increased thrombo-embolic events, with thrombi most frequently located in the left atrial appendage (LAA). Asymmetric dimethylarginine (ADMA), a potent endogenous inhibitor of nitric oxide synthase, is elevated in subjects with AF. We investigated the relationship between ADMA and risk of LAA thrombus in patients with non-valvular AF. METHODS AND RESULTS: A total of 223 consecutive patients with non-valvular AF were enrolled (63 ± 10 years, 65% male). LAA thrombus was detected in 27 subjects by transesophageal echocardiography. Serum ADMA was significantly increased (2.5 ± 0.6 μmol/L vs 1.8 ± 0.4 μmol/L, p<0.001), while serum nitrite/nitrate was significantly reduced in patients with LAA thrombus (30.3 ± 7.1 μmol/L vs 48.4 ± 9.3 μmol/L, p<0.001). ADMA was positively correlated with age and left atrium diameter, and was negatively correlated with nitrite/nitrate and LAA peak flow velocity. The area under the receiver operating characteristic curve of ADMA predicting thrombus was 0.84. In multivariate logistic regression analysis, ADMA (OR 4.0, 95% CI 1.2-13.0; p=0.003) was one of independent risk factors for LAA thrombus. CONCLUSIONS: Our study suggested that high ADMA was independently associated with the presence of LAA thrombus in patients with non-valvular AF.
Authors: Ilkka Seppälä; Marcus E Kleber; Steve Bevan; Leo-Pekka Lyytikäinen; Niku Oksala; Jussi A Hernesniemi; Kari-Matti Mäkelä; Peter M Rothwell; Cathie Sudlow; Martin Dichgans; Nina Mononen; Efthymia Vlachopoulou; Juha Sinisalo; Graciela E Delgado; Reijo Laaksonen; Tuomas Koskinen; Hubert Scharnagl; Mika Kähönen; Hugh S Markus; Winfried März; Terho Lehtimäki Journal: Sci Rep Date: 2016-03-17 Impact factor: 4.379