The Relationship of Left Ventricular Diastolic Dysfunction and Asymmetrical Dimethylarginine as a Biomarker of Endothelial Dysfunction with Cardiovascular Risk Assessed by Systematic Coronary Risk Evaluation2 Algorithm and Heart Failure—A Cross-Sectional Study

Figures

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  Figure 1. ROC curve comparing NT-proBNP and ADMA in different groups of subjects with normal LVDF and any form of LVDD. NT-proBNP was a better diagnostic indicator of the existence of any grade of LVDD (AUC of 0.859, 95% CI 0.807–0.912, sensitivity 65.7%, specificity 100%, cut-off values > 141 ng/L, Youden index 0.66, p < 0.001) compared to ADMA (AUC 0.777, 95% CI 0.708–0.845, sensitivity 56%, specificity 93.2%, cut-off values ≤ 0.392 µmol/L, Youden index 0.49, p < 0.001).

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  Figure 2. ROC curve comparing NT-proBNP and ADMA in different groups of subjects with LVDD grade 1 and LVDD grades 2 and 3. NT-proBNP was a better diagnostic indicator of the existence of LVDD grades 2 and 3 (AUC 0.889, 95% CI 0.833–0.945, sensitivity 73.9%, specificity 89.1%, cut-off values > 220 ng/L, Youden index 0.63, p < 0.001) compared to ADMA (AUC 0.673, 95% CI 0.570–0.777, sensitivity 72.7%, specificity 60.9%, cut-off values ≤ 0.433 µmol/L, Youden index 0.34, p = 0.001).

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  Figure 3. ROC curve comparing NT-proBNP and ADMA in different groups of subjects with LVDD grade 2 and LVDD grade 3. NT-proBNP again proved to be a significant parameter in differentiating LVDD grade 2 from LVDD grade 3 (AUC 0.904, 95% CI 0.844–0.964, sensitivity 81%, specificity 87%, cut-off values > 784 ng/L, Youden index 0.68, p < 0.001), while ADMA did not show statistical significance in differentiating LVDD grades 2 and 3 (AUC 0.582, 95% CI 0.461–0.703, sensitivity 67%, specificity 54%, cut-off values > 0.24 µmol/L, Youden index 0.21, p = 0.18).

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  Figure 4. ROC analysis in predicting the laboratory values of ADMA and NT-proBNP using more clinically accessible parameters used for SCORE2. ADMA used the following parameters: AUC 0.796, 95% CI 0.730–0.853, sensitivity 97.6% and specificity 80.6% at cut-off values ≤ 0.475 µmol/L, Youden index 0.482, p < 0.001. NT-proBNP had the following parameters: AUC 0.810, 95% CI 0.744–0.865, sensitivity 62.7% and specificity 97.2% at cut-off values > 0.136 ng/L, Youden index 0.599, p < 0.001.