Asymmetric Dimethylarginine Concentration and Early Recurrence of Atrial Fibrillation after Electrical Cardioversion

Xia, Wei; Qu, Xiufen; Yu, Ying; Zhang, Xueli; Feng, Wang; Song, Ying

doi:10.1111/j.1540-8159.2008.01131.x

Cited by 22 publications

(19 citation statements)

References 31 publications

(29 reference statements)

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“…The lack of a predictive value of ADMA levels with regard to AF recurrence found in our study contrasts findings in the study by Xia et al [18]. These authors concluded that the ADMA level measured before cardioversion was an independent predictor of AF recurrence.…”

Section: Discussioncontrasting

confidence: 57%

“…Previous studies on the relation between ADMA and rhythm outcome after cardioversion have not taken into account the role of L -arginine, the substrate for NO, which may counterbalance the inhibitory effect of ADMA on NO synthase [18,19]. To the best of our knowledge, this is the first study on the levels of L -arginine, ADMA and the L -arginine/ADMA ratio and their relation to the maintenance of sinus rhythm after electrical cardioversion for AF, and the effects of angiotensin receptor blockade on these variables.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, another small study indicated that high levels of ADMA were associated with an increased risk of AF recurrence within 1 month after ECV [18], whereas treatment with rosuvastatin reduced both early recurrences of AF and ADMA levels after ECV [19]. …”

Section: Introductionmentioning

confidence: 99%

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<i>L</i>-Arginine, Asymmetric Dimethylarginine and Rhythm Outcome after Electrical Cardioversion for Atrial Fibrillation

Tveit¹,

Arnesen²,

Smith³

et al. 2010

Cardiology

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Objectives: It was our aim to study the levels of L-arginine, the substrate for nitric oxide and asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, and their relation to the maintenance of sinus rhythm after electrical cardioversion for atrial fibrillation (AF), as well as the effects of angiotensin receptor blockade on these variables. Methods: In a double-blind, placebo-controlled study, patients with persistent AF were randomised to receive candesartan 8 mg once daily or placebo for 3–6 weeks before and candesartan 16 mg once daily or placebo for 6 months after cardioversion. As part of this study, plasma levels of L-arginine and ADMA were measured at baseline and at the end of the study. Results: Baseline levels of L-arginine, ADMA and the L-arginine/ADMA ratio were not predictive of rhythm outcome, and their levels were not influenced by treatment with candesartan. However, the L-arginine/ADMA ratio increased in patients who remained in sinus rhythm (n = 37) for 6 months when compared with patients with AF recurrence (n = 61; p = 0.008). Conclusion: Neither L-arginine nor ADMA or their ratio were predictive of rhythm outcome after cardioversion, and they were not influenced by treatment with candesartan. However, the L-arginine/ADMA ratio increased in patients still in sinus rhythm 6 months after cardioversion.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

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<i>L</i>-Arginine, Asymmetric Dimethylarginine and Rhythm Outcome after Electrical Cardioversion for Atrial Fibrillation

Tveit¹,

Arnesen²,

Smith³

et al. 2010

Cardiology

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“…Elevation in plasma levels of the endogenous NOS inhibitor asymmetric dimethylarginine (ADMA) is known to be associated with adverse cardiovascular events following cardiac [58] and non-cardiac [59] surgeries, and in patients with peripheral artery disease [60]. Recently, elevated plasma ADMA levels have been associated with increased risk of AF [61,62]. Xia et al reported that in patients undergoing electrical cardioversion, an elevation in pre-cardioversion ADMA was a predictor of arrhythmia recurrence [62].…”

Section: Evidence From Human Studiesmentioning

confidence: 99%

“…Recently, elevated plasma ADMA levels have been associated with increased risk of AF [61,62]. Xia et al reported that in patients undergoing electrical cardioversion, an elevation in pre-cardioversion ADMA was a predictor of arrhythmia recurrence [62]. The authors went on to demonstrate that treatment with rosuvastatin significantly reduces both plasma ADMA levels and recurrence of arrhythmia suggesting that enhancement of basal NO production via reductions in ADMA may provide protection against risk of arrhythmia [61].…”

Section: Evidence From Human Studiesmentioning

confidence: 99%

Protective Role of Nitric Oxide Against Cardiac Arrhythmia - An Update

Burger¹

2011

TONOJ

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Nitric oxide (NO), a ubiquitous cell signalling molecule, plays an important role in the regulation of cardiovascular function. NO is produced by all cell types in the heart and is widely implicated in vasodilation, inflammation, ischemic preconditioning and cell death. Mounting evidence now suggests that NO also provides protection against cardiac arrhythmia. Pharmacological studies using NO precursors and NO donors have observed an anti-arrhythmic effect, while inhibitors of NO biosynthesis increase arrhythmia, or attenuate anti-arrhythmic actions in a variety of animal models. Additionally, genetic studies from animals deficient in nitric oxide synthase (NOS) enzymes have found increased susceptibility to pharmacological or ischemia-induced arrhythmia while transgenic mice overexpressing certain NOS isozymes may be protected. In the human population polymorphisms in NOS enzymes, or differences in the levels of endogenous inhibitors of NO synthesis may also be important determinants of arrhythmic susceptibility. The precise mechanisms of NO-mediated protection from arrhythmia are still under investigation but may include reductions in calcium overload, regulation of gap junction/connexin expression, reductions in oxidative stress, and regulation of sympathetic activity. This review examines the pharmacological, genetic, and clinical evidence of a role for NO in reducing cardiac arrhythmia and discusses possible mechanisms of NO-mediated protection against arrhythmia.

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Effect of fish oil on circulating asymmetric dimethylarginine and adiponectin in overweight or obese patients with atrial fibrillation

Khorrami

Hosseinzadeh‐Attar

Esmaillzadeh

et al. 2020

Food Science & Nutrition

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Obesity and adipose-derived peptides might be involved in the pathogenesis of atrial fibrillation (AF). Adiponectin plays a major role in the modulation of several metabolic pathways, and asymmetric dimethylarginine (ADMA) has been suggested to be predictive of AF and associated adverse events. The aim of this study was to investigate the effect of fish oil supplementation on circulating adiponectin and ADMA in overweight or obese patients with persistent AF. In this randomized, double-blind, placebo-controlled trial, 80 overweight or obese (body mass index (BMI) ≥ 25 kg/m 2 ) patients with persistent AF were randomly assigned to two groups to receive either 2 g/day fish oil or placebo, for 8 weeks. Serum levels of adiponectin and ADMA, and anthropometric indexes were measured. This study showed that serum adiponectin concentrations increased significantly following fish oil supplementation compared with the placebo group (13.15 ± 7.33 vs. 11.88 ± 6.94 µg/ml; p = .026). A significant reduction was also observed in serum ADMA levels in the fish oil compared with the placebo group following the intervention (0.6 ± 0.13 vs. 0.72 ± 0.15 µmol/L; p = .001). The changes in serum adiponectin and ADMA concentrations remained significant after adjustments for baseline values, age, sex, and changes of BMI and waist circumference (p = .011 and p = .001, respectively). In conclusion, 8 weeks supplementation with fish oil increased serum adiponectin and decreased ADMA concentrations in overweight or obese patients with persistent AF. As adiponectin and ADMA are suggested to be involved in many pathways associated with AF, the current findings might be promising in the clinical management of this disease, an issue that needs further investigations. K E Y W O R D Sadiponectin, asymmetric dimethylarginine, atrial fibrillation, fish oil, obesity

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Asymmetric Dimethylarginine Concentration and Early Recurrence of Atrial Fibrillation after Electrical Cardioversion

Abstract: Our data suggest that high levels of ADMA are associated with an increased risk of AF recurrence within 1 month after electrical CV, supporting the hypothesis that ADMA might participate in the process of atrial remodeling.

Cited by 22 publications

References 31 publications

<i>L</i>-Arginine, Asymmetric Dimethylarginine and Rhythm Outcome after Electrical Cardioversion for Atrial Fibrillation

<i>L</i>-Arginine, Asymmetric Dimethylarginine and Rhythm Outcome after Electrical Cardioversion for Atrial Fibrillation

Protective Role of Nitric Oxide Against Cardiac Arrhythmia - An Update

Effect of fish oil on circulating asymmetric dimethylarginine and adiponectin in overweight or obese patients with atrial fibrillation

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