Key result
Pharmacological ADHF therapy is linked to a ~14% increase in plasma ADMA levels at one day.
Why the study?
Does acute pharmacological treatment alter ADMA and SDMA plasma levels in patients with acute decompensated heart failure?
Observational (n=18)
Open-label
No
Does acute pharmacological treatment alter ADMA and SDMA plasma levels in patients with acute decompensated heart failure?
Absolute Event Rate: 0.75% vs 0.66%
p-value: p=<0.01
Acute pharmacological treatment of decompensated heart failure is associated with a significant early increase in ADMA and SDMA plasma levels, likely reflecting altered metabolism and renal function.
ADMA rise during ADHF therapy may reflect renal-metabolic shifts; hypothesis-generating and should not yet change practice.
Asymmetric dimethylarginine (ADMA) plays a crucial role in the arginine-nitric oxide (NO) pathway. NO plays an important role in controlling vascular tone and regulates the contractile properties of cardiac myocytes. The purpose of this study was to investigate the effect of pharmacological treatment on asymmetrical dimethylarginine (ADMA) plasma levels in patients with acute congestive heart failure (HF). Patients with symptomatic acute congestive HF (NYHA Class III-IV) and impaired left ventricular (LV) function (ejection fraction less than 40 percent) were included in the study. ADMA and SDMA concentrations were assessed before and after pharmacological treatment in 18 critically ill patients on the intensive care unit by high performance liquid chromatography. All patients received a complete pharmacological treatment (diuretics, digoxin, ACE-inhibitors or angiotensin receptor blockers, and nitroglicerin) for the treatment of acute congestive HF. ADMA plasma levels of critically ill patients were significantly higher after pharmacological treatment respect baseline values (pre-treatment). In critically ill patients with acute congestive HF acute renal impairment function and the modulation of NOS determine plasma ADMA/SDMA levels after therapy.
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Graziano Riccioni (2011) conducted an observational in Acute decompensated heart failure (n=18). Pharmacological treatment (diuretics, digoxin, ACE-inhibitors/ARBs, nitroglycerin) vs. Baseline (pre-treatment) was evaluated on ADMA plasma levels (p=<0.01). Pharmacological treatment for acute decompensated heart failure significantly increased ADMA plasma levels from 0.66 µmol/L at baseline to 0.75 µmol/L after one day of therapy (p<0.01).
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