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Start Over Author "Keki S" Topic pericardial fluid
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1. Elevated Levels of Asymmetric Dimethylarginine (ADMA) in the Pericardial Fluid of Cardiac Patients Correlate with Cardiac Hypertrophy.

Author

Nemeth Z, Cziraki A, Szabados S, Biri B, Keki S, and Koller A

Subjects
Adult, Arginine blood, Cardiomegaly diagnosis, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Myocardium pathology, Nitric Oxide metabolism, Nitric Oxide physiology, Nitric Oxide Synthase antagonists & inhibitors, Ventricular Remodeling, Arginine analogs & derivatives, Arginine metabolism, Cardiomegaly metabolism, Pericardial Fluid metabolism
Abstract

Background: Pericardial fluid (PF) contains several biologically active substances, which may provide information regarding the cardiac conditions. Nitric oxide (NO) has been implicated in cardiac remodeling. We hypothesized that L-arginine (L-Arg) precursor of NO-synthase (NOS) and asymmetric dimethylarginine (ADMA), an inhibitor of NOS, are present in PF of cardiac patients and their altered levels may contribute to altered cardiac morphology., Methods: L-Arg and ADMA concentrations in plasma and PF, and echocardiographic parameters of patients undergoing coronary artery bypass graft (CABG, n = 28) or valve replacement (VR, n = 25) were determined., Results: We have found LV hypertrophy in 35.7% of CABG, and 80% of VR patients. In all groups, plasma and PF L-Arg levels were higher than that of ADMA. Plasma L-Arg level was higher in CABG than VR (75.7 ± 4.6 μmol/L vs. 58.1 ± 4.9 μmol/L, p = 0.011), whereas PF ADMA level was higher in VR than CABG (0.9 ± 0.0 μmol/L vs. 0.7 ± 0.0 μmol/L, p = 0.009). L-Arg/ADMA ratio was lower in the VR than CABG (VRplasma: 76.1 ± 6.6 vs. CABGplasma: 125.4 ± 10.7, p = 0.004; VRPF: 81.7 ± 4.8 vs. CABGPF: 110.4 ± 7.2, p = 0.009). There was a positive correlation between plasma L-Arg and ADMA in CABG (r = 0.539, p = 0.015); and plasma and PF L-Arg in CABG (r = 0.357, p = 0.031); and plasma and PF ADMA in VR (r = 0.529, p = 0.003); and PF L-Arg and ADMA in both CABG and VR (CABG: r = 0.468, p = 0.006; VR: r = 0.371, p = 0.034). The following echocardiographic parameters were higher in VR compared to CABG: interventricular septum (14.7 ± 0.5 mm vs. 11.9 ± 0.4 mm, p = 0.000); posterior wall thickness (12.6 ± 0.3 mm vs. 11.5 ± 0.2 mm, p = 0.000); left ventricular (LV) mass (318.6 ± 23.5 g vs. 234.6 ± 12.3 g, p = 0.007); right ventricular (RV) (33.9 ± 0.9 cm2 vs. 29.7 ± 0.7 cm2, p = 0.004); right atrial (18.6 ± 1.0 cm2 vs. 15.4 ± 0.6 cm2, p = 0.020); left atrial (19.8 ± 1.0 cm2 vs. 16.9 ± 0.6 cm2, p = 0.033) areas. There was a positive correlation between plasma ADMA and RV area (r = 0.453, p = 0.011); PF ADMA and end-diastolic (r = 0.434, p = 0.015) and systolic diameter of LV (r = 0.487, p = 0.007); and negative correlation between PF ADMA and LV ejection fraction (r = -0.445, p = 0.013) in VR., Conclusion: We suggest that elevated levels of ADMA in the PF of patients indicate upregulated RAS and reduced bioavailability of NO, which can contribute to the development of cardiac hypertrophy and remodeling.

Published
2015
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2. L-arginine and asymmetric dimethyl arginine (ADMA) levels in human pericardial fluid in patients with open cardiac surgery.

Author

Nemeth, Z., Cziraki, A., Keki, S., Biri, B., Szabados, S., Horvath, I., Parniczky, A., Seffer, I., Miseta, A., and Koller, A.

Subjects
CARDIOVASCULAR diseases risk factors, ASYMMETRIC dimethylarginine, NITRIC oxide
Abstract

Background-Recent studies provide evidence that vasoactive active substances are present in the pericardial fluid (PF), which levels may change in cardiovascular diseases. Increasing evidence suggests that methylated L-arginine derivative, asymmetric dimethylarginine (ADMA) is a risk factor of most cardiovascular diseases. Furthermore, it has been shown that ADMA inhibits endothelium-dependent vasodilation by interfering with endothelial nitric oxide (eNOS) activity and/or eliciting oxidative stress, both of which interfere with the bioavailability of endothelium derived nitric oxide (NO). We hypothesized that ADMA levels in the PF reflects/contributes the pathological processes in the heart. Methods and patients -Patients were classified into two groups according to the type of surgery: coronary artery bypass graft (CABG, n = 28) and valve replacement (VR, n = 16). Blood and PF were collected during CABG and VR surgery. Levels of L-arginine and ADMA were determined in plasma and PF (with fluorescent detection after liquid chromatographic separation) of patients underwent CABG and VR surgery, compared them and an indicator of eNOS substrate availability, L-arginine/ADMA ratios were calculated. Values are expressed as means ± S.E.M. Comparisons between groups were performed using paired Student's t-test. Results--We found that in CABG group, the L-arginine levels were similar in plasma and PF (75.7±4.6 micromol/L vs. 76.9±4.4 micromol/L). In VR group, the L-arginine levels were significantly (p<0.05) lower in plasma compared to the PF (57.7±5.9 micromol/L vs. 71.5±5.7 micromol/L). In CABG group, the ADMA levels were the same in plasma and PF (0.7±0.0 micromol/L vs. 0.7±0.1 micromol/L). In VR group, the ADMA levels were similar in plasma and PF (0.8±0.1 micromol/L vs. 0.9±0.1micromol/L). In CABG group, the L-arginine/ADMA ratios were significantly higher compared to the VR group in both plasma (125.4±10.7 vs. 74.9±8.3) and PF (110.4±7.2 vs. 79.5±5.8). Conclusion--Based on these findings we propose that the lower L-arginine/ADMA ratios suggest increased methylation of L-arginine and limited substrate availability for eNOS and thus impaired nitric oxide signaling and vascular function in patients with heart valve disease. [ABSTRACT FROM AUTHOR]

Published
2013

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