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Plasma l-arginine levels distinguish pulmonary arterial hypertension from left ventricular systolic dysfunction

Sandqvist, Anna; Schneede, Jörn; Kylhammar, David LU ; Henrohn, Dan; Lundgren, Jakob LU ; Hedeland, Mikael; Bondesson, Ulf; Rådegran, Göran LU and Wikström, Gerhard (2018) In Heart and Vessels 33(3). p.255-263
Abstract

Pulmonary arterial hypertension (PAH) is a life-threatening condition, characterized by an imbalance of vasoactive substances and remodeling of pulmonary vasculature. Nitric oxide, formed from l-arginine, is essential for homeostasis and smooth muscle cell relaxation in PAH. Our aim was to compare plasma concentrations of l-arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) in PAH compared to left ventricular systolic dysfunction (LVSD) and healthy subjects. This was an observational, multicenter study comparing 21 patients with PAH to 14 patients with LVSD and 27 healthy subjects. Physical examinations were obtained and blood samples were collected. Plasma levels of ADMA, SDMA, l-arginine, l-ornithine,... (More)

Pulmonary arterial hypertension (PAH) is a life-threatening condition, characterized by an imbalance of vasoactive substances and remodeling of pulmonary vasculature. Nitric oxide, formed from l-arginine, is essential for homeostasis and smooth muscle cell relaxation in PAH. Our aim was to compare plasma concentrations of l-arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) in PAH compared to left ventricular systolic dysfunction (LVSD) and healthy subjects. This was an observational, multicenter study comparing 21 patients with PAH to 14 patients with LVSD and 27 healthy subjects. Physical examinations were obtained and blood samples were collected. Plasma levels of ADMA, SDMA, l-arginine, l-ornithine, and l-citrulline were analyzed using liquid chromatography–tandem mass spectrometry (LC–MS/MS). Plasma levels of ADMA and SDMA were higher, whereas l-arginine and l-arginine/ADMA ratio were lower in PAH patients compared to healthy subjects (p < 0.001). Patients with PAH also had lower levels of l-arginine than patients with LVSD (p < 0.05). l-Arginine correlated to 6 min walking distance (6MWD) (rs = 0.58, p = 0.006) and l-arginine/ADMA correlated to WHO functional class (rs = −0.46, p = 0.043) in PAH. In conclusion, l-arginine levels were significantly lower in treatment naïve PAH patients compared to patients with LVSD. Furthermore, l-arginine correlated with 6MWD in PAH. l-arginine may provide useful information in differentiating PAH from LVSD.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dimethylarginines, l-Arginine, Left heart failure, Pulmonary arterial hypertension, Systolic dysfunction
in
Heart and Vessels
volume
33
issue
3
pages
255 - 263
publisher
Springer
external identifiers
  • scopus:85030313830
ISSN
0910-8327
DOI
10.1007/s00380-017-1055-7
language
English
LU publication?
yes
id
592c5af7-6059-4385-b983-0385a54f6c16
date added to LUP
2017-11-02 14:27:50
date last changed
2018-10-07 05:01:46
@article{592c5af7-6059-4385-b983-0385a54f6c16,
  abstract     = {<p>Pulmonary arterial hypertension (PAH) is a life-threatening condition, characterized by an imbalance of vasoactive substances and remodeling of pulmonary vasculature. Nitric oxide, formed from l-arginine, is essential for homeostasis and smooth muscle cell relaxation in PAH. Our aim was to compare plasma concentrations of l-arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) in PAH compared to left ventricular systolic dysfunction (LVSD) and healthy subjects. This was an observational, multicenter study comparing 21 patients with PAH to 14 patients with LVSD and 27 healthy subjects. Physical examinations were obtained and blood samples were collected. Plasma levels of ADMA, SDMA, l-arginine, l-ornithine, and l-citrulline were analyzed using liquid chromatography–tandem mass spectrometry (LC–MS/MS). Plasma levels of ADMA and SDMA were higher, whereas l-arginine and l-arginine/ADMA ratio were lower in PAH patients compared to healthy subjects (p &lt; 0.001). Patients with PAH also had lower levels of l-arginine than patients with LVSD (p &lt; 0.05). l-Arginine correlated to 6 min walking distance (6MWD) (r<sub>s</sub> = 0.58, p = 0.006) and l-arginine/ADMA correlated to WHO functional class (r<sub>s</sub> = −0.46, p = 0.043) in PAH. In conclusion, l-arginine levels were significantly lower in treatment naïve PAH patients compared to patients with LVSD. Furthermore, l-arginine correlated with 6MWD in PAH. l-arginine may provide useful information in differentiating PAH from LVSD.</p>},
  author       = {Sandqvist, Anna and Schneede, Jörn and Kylhammar, David and Henrohn, Dan and Lundgren, Jakob and Hedeland, Mikael and Bondesson, Ulf and Rådegran, Göran and Wikström, Gerhard},
  issn         = {0910-8327},
  keyword      = {Dimethylarginines,l-Arginine,Left heart failure,Pulmonary arterial hypertension,Systolic dysfunction},
  language     = {eng},
  number       = {3},
  pages        = {255--263},
  publisher    = {Springer},
  series       = {Heart and Vessels},
  title        = {Plasma l-arginine levels distinguish pulmonary arterial hypertension from left ventricular systolic dysfunction},
  url          = {http://dx.doi.org/10.1007/s00380-017-1055-7},
  volume       = {33},
  year         = {2018},
}