The L-Arginine–Asymmetric Dimethylarginine Ratio is an Independent Predictor of Mortality in Dilated Cardiomyopathy
Abstract
Background Asymmetric dimethylarginine (ADMA) is associated with increased mortality in patients with chronic heart failure but it remains unclear if the etiology of heart failure influences the prognostic value of dimethylarginines.Methods and results L-Arginine, ADMA, and symmetric dimethylarginine (SDMA) were measured by liquid chromatography-tandem mass spectrometry in 341 patients with chronic heart failure due to dilated cardiomyopathy (DCM; n = 226) or ischemic cardiomyopathy (ICM; n = 115). Median (interquartile range [IQR]) ADMA and SDMA plasma levels were higher, L-arginine and the L-arginine-ADMA ratio were lower in patients with severe forms of heart failure (New York Heart Association (NYHA) functional class III or IV) compared with milder forms (NYHA functional class I or II) (ADMA 0.57 (0.14) μmol/L vs 0.54 (0.12) μmol/L [P < .001]; SDMA 0.47 (0.27) μmol/L vs 0.37 (0.13) μmol/L [P < .001]; L-arginine 81.8 (39.1) μmol/L vs 92.6 (39.3) μmol/L [P < .01]), but no significant differences were observed between the different etiologies. The L-arginine-ADMA ratio was associated with outcome only in patients with DCM. In multivariate analysis, the mortality risk of DCM patients was significantly lower for those in the highest quartile compared with the lowest quartile during a median observation time of 3.3 years (hazard ratio 0.31, 95% CI 0.11-0.88; P = .028, adjusted for other risk factors).Conclusions DCM patients with unfavourable L-arginine-ADMA ratio are at increased risk for death.
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The ratio of l-arginine to ADMA appears to be a better indicator of cardiovascular risk.
“As pointed out above, the ratio of l-arginine to ADMA appears to be a better indicator of cardiovascular risk (28, 103, 104, 606, 1050).”
From Sources of Vascular Nitric Oxide and Reactive Oxygen Species and Their Regulation (2019) · cites this paper as [28]
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Sources of Vascular Nitric Oxide and Reactive Oxygen Species and Their Regulation
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- Authors
- Anderssohn, M., Rosenberg, M., Schwedhelm, E., Zugck, C., Lutz, M., Lüneburg, N., Frey, N., & Böger, R. H.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- University Hospital Schleswig-Holstein (DE)
- University Hospital Heidelberg (DE)
- Corresponding author
- Anderssohn, Maike
- Venue
- Journal of Cardiac Failure
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 18
- Issue
- 12
- Pages
- 904-911
- ISSN
- 1071-9164 (ISSN-L)
- OpenAlex
- W1987068861
- Cited by
- 44
- References
- 32
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 3 · 2022: 2 · 2020: 3 · 2018: 6 · 2017: 4 · 2016: 6 · 2015: 7 · 2014: 6 · 2013: 4
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiac Failure (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cancer-related gene regulation
- Keywords
- L-arginine, asymmetric dimethylarginine, symmetric dimethylarginine, dilated cardiomyopathy, ischemic cardiomyopathy, chronic heart failure, mortality prediction, prognostic factors, dimethylarginines, endothelial dysfunction
- MeSH terms
- Arginine, Cardiomyopathy, Dilated, Chromatography, Liquid, Creatinine, Female, Humans, Male, Middle Aged, Cardiomyopathies, Peptide Fragments, Severity of Illness Index, Biomarkers, Multivariate Analysis, Myocardial Ischemia, Natriuretic Peptide, Brain, Kaplan-Meier Estimate, Tandem Mass Spectrometry
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