Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/42227
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Type: Journal article
Title: Aortic stenosis is associated with elevated plasma levels of asymmetric dimethylarginine (ADMA)
Author: Ngo, D.
Heresztyn, T.
Mishra, K.
Marwick, T.
Horowitz, J.
Citation: Nitric Oxide-Biology and Chemistry, 2007; 16(2):197-201
Publisher: Academic Press Inc Elsevier Science
Issue Date: 2007
ISSN: 1089-8603
1089-8611
Statement of
Responsibility: 
Doan T.M. Ngo, Tamila Heresztyn, Kumaril Mishra, Thomas H. Marwick and John D. Horowitz
Abstract: We tested the hypothesis that the presence of aortic stenosis (AS) is associated with elevation of plasma levels of asymmetric dimethylarginine (ADMA), a physiological inhibitor of nitric oxide synthase, a mediator and marker of endothelial dysfunction and an indicator of incremental cardiovascular risk.The presence of aortic sclerosis (ASC), the precursor of AS is independently associated both with endothelial dysfunction, and with incremental coronary event risk. It remains uncertain whether elevations of ADMA levels might mediate endothelial dysfunction in these conditions.Forty two consecutive patients referred for echocardiography for evaluation of AS, who had calculated aortic valve areas of <1.4 cm(2) (AS group) were evaluated together with 42 consecutive age-matched referred patients (non-AS group). Plasma ADMA levels were measured by high-performance liquid chromatography (HPLC). Determinants of elevation of plasma ADMA levels were identified via stepwise multiple linear regression analysis.Plasma ADMA levels were not statistically different between the AS and non-AS group (median 0.59 vs 0.54 micromol/L, p=0.13, Mann-Whitney test) on univariate analysis. However, in backward stepwise multiple linear regression, the presence of AS was a significant predictor of elevated ADMA levels (p=0.04, 95% CI=0.001, 0.072). In addition, elevated plasma ADMA levels were also associated with history of atrial fibrillation (p=0.009, 95% CI=0.015, 0.100), and negatively associated with creatinine clearance (p=0.01, 95% CI=-0.002, 0.000), and the use of statin therapy (p=0.01, 95% CI=-0.081, -0.011).AS is independently associated with elevation of ADMA levels, beyond that implied by "conventional" risk factors for endothelial dysfunction. The clinical status of AS as an incremental marker of cardiovascular risk may reflect ADMA-mediated endothelial dysfunction.
Keywords: Humans; Aortic Valve Stenosis; Arginine; Chromatography, High Pressure Liquid
Description: Copyright © 2006 Elsevier Inc. All rights reserved.
RMID: 0020070154
DOI: 10.1016/j.niox.2006.10.003
Appears in Collections:Medicine publications

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