Left ventricular hypertrophy, cardiac remodeling and asymmetric dimethylarginine (ADMA) in hemodialysis patients

Zoccali, Carmine; Mallamaci, Francesca; Maas, Renke; Benedetto, Francesco; Tripepi, Giovanni; Malatino, Lorenzo; Cataliotti, Alessandro; Bellanuova, Ignazio; Böger, Rainer H.; Investigators, None on behalf of The Creed

doi:10.1046/j.1523-1755.2002.00437.x

Cited by 198 publications

(151 citation statements)

References 36 publications

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“…[18] Several experimental studies have also suggested a relationship between NO inhibition and LVH. [19] Similar to study reported by Zoccali et al in hemodialysis patients, [9] we found a positive relationship between LVMI and serum ADMA levels in CAPD patients. They also suggested that ADMA is an independent risk factor in left ventricular hypertrophy development in hemodialysis patients.…”

supporting

confidence: 90%

“…They also suggested that ADMA is an independent risk factor in left ventricular hypertrophy development in hemodialysis patients. [9] Although a significant relationship between ADMA and LVMI was demonstrated in the present study, linear regression analysis did not show ADMA as an independent risk factor for LVH. This may be due to the small number of patients in our study.…”

contrasting

confidence: 83%

“…[4,5,7,8] This hypothesis was supported by Zoccali et al, who demonstrated a relationship between LVH and ADMA in hemodialysis patients. [9] It has been postulated that cardiovascular mortality in dialysis patients decreases in the presence of residual renal function (RRF). [10] To the best of our knowledge, there is no study evaluating the relationship between ADMA level, RRF, and cardiovascular disease in ESRD patients.…”

Section: Introductionmentioning

confidence: 99%

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The Relationship among Asymmetric Dimethylarginine (ADMA) Levels, Residual Renal Function, and Left Ventricular Hypertrophy in Continuous Ambulatory Peritoneal Dialysis Patients

et al. 2008

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Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelial-based nitric oxide synthase. Its level is increased by end stage renal disease. However, most studies showing an increase in ADMA in dialysis patients have focused on hemodialysis. Results with peritoneal dialysis patients have been more inconclusive. Recent studies suggest that ADMA may be a new cardiovascular risk factor. The aim of the present study was to evaluate the relationship between ADMA levels, residual renal function, and left ventricular hypertrophy in peritoneal dialysis patients. Serum ADMA measurements and echocardiographic evaluations were performed in 54 peritoneal dialysis patients and 26 healthy volunteers. Residual renal function was measured in peritoneal dialysis patients by urea clearance from a urine collection. Thirty-two of the 54 peritoneal dialysis patients had residual renal function. ADMA levels of the peritoneal dialysis group were found to be significantly higher than those of healthy individuals ( p = 0.03). Within the peritoneal dialysis group, ADMA levels of patients with residual renal function were significantly lower than those without residual renal function (p = 0.01), though they were still higher than the ADMA levels of the control group (p = 0.04). Serum levels of ADMA were positively correlated with left ventricular mass index (r = 0.29, p = 0.01) and negatively correlated with early mitral inflow velocity (Em) (r = −0.28, p = 0.01), Em/Late mitral inflow velocity (Am) (r = −0,32, p = 0.00), and isovolumetric relaxation time (r = −0.30, p = 0.01). In conclusion, increased ADMA levels seem to be associated with left ventricular hypertrophy in peritoneal dialysis patients, and residual renal function may lead to a reduction of serum ADMA levels.

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supporting

confidence: 90%

contrasting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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The Relationship among Asymmetric Dimethylarginine (ADMA) Levels, Residual Renal Function, and Left Ventricular Hypertrophy in Continuous Ambulatory Peritoneal Dialysis Patients

et al. 2008

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“…Short-term elimination of circulating ADMA by hemodialysis was associated with improved endothelial function in ESRD patients (27). Furthermore, plasma ADMA concentrations have been associated with carotid intima-media thickness and left ventricular hypertrophy in patients with ESRD, thereby suggesting that ADMA might play an important role in the initiation and progression of atherosclerosis, and therefore, it might be involved in the development of adverse cardiovascular events in patients with ESRD and CKD (28,29). Accumulating evidence indicates that albuminuria may be a reflection of generalized alteration of endothelial permeability and endothelial dysfunction (30), and it might be a strong predictor of future cardiovascular events, largely independent of renal function (31).…”

Section: Discussionmentioning

confidence: 99%

Asymmetric Dimethylarginine and Clinical Outcomes in Chronic Kidney Disease

Chung²,

Lin

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Elevated plasma level of asymmetric dimethylarginine (ADMA) have been reported to be associated with endothelial dysfunction and atherosclerosis risk factors, and may predict cardiovascular events in patients with ESRD. In this study, we aimed to assess the association between plasma ADMA and long-term outcome in a cohort of patients with stage 3 to 4 chronic kidney disease (CKD).Design, setting, participants, & measurements From July 2006 to June 2009, 298 consecutive patients with stage 3 to 4 CKD scheduled to undergo coronary angiography were recruited. Plasma ADMA levels were determined using HPLC. ResultsThe mean age was 73 Ϯ 10 years. Approximately half of the patients had diabetes and 88 patients had proteinuria. The baseline estimated GFR (eGFR) was 44 Ϯ 13 ml/min per 1.73 m 2 . The plasma ADMA levels of the patients with proteinuria were significantly higher than those without. The plasma ADMA levels correlated significantly with eGFR. During the median follow-up period of 2.7 years, we observed 26 all-cause deaths, 12 nonfatal myocardial infarctions, and 2 strokes. Multivariate Cox analysis revealed that an increase of 0.1 mol/L in plasma ADMA level was associated with a 37% increased risk of the composite outcomes of all-cause deaths, nonfatal myocardial infarctions, and strokes. ConclusionsIn this elder and high-risk population with stage 3 to 4 CKD, high plasma ADMA level was associated with low eGFR and macroalbuminuria. Furthermore, high plasma ADMA level appeared to be an independent predictor of long-term outcome.

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“…Chronic renal failure associated with hypertension [1,3,14,15] Stroke [16,17] Pulmonary hypertension [18][19][20] Left ventricular hypertrophy [21,22] Type II diabetes [23][24][25] Pre-eclampsia [26,27] Heart failure [28] Ischaemia [29,30] Hypercholesterolemia [31,32] Atherosclerosis [33,34] Alzheimers* [35,36] …”

Section: Cardiovascular Disorder Change In Adma Referencementioning

confidence: 99%

C-Reactive Protein and Asymmetric Dimethylarginine: Markers or Mediators in Cardiovascular Disorders?

Smith¹

2007

CPD

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This is an electronic version of an article published in Current Pharmaceutical Design, 13 (16). pp. [1619][1620][1621][1622][1623][1624][1625][1626][1627][1628][1629] 2007. The definitive version is available online at:http://www.bentham.org/cpd/index.htmThe WestminsterResearch online digital archive at the University of Westminster aims to make the research output of the University available to a wider audience. Copyright and Moral Rights remain with the authors and/or copyright owners. Users are permitted to download and/or print one copy for non-commercial private study or research. Further distribution and any use of material from within this archive for profit-making enterprises or for commercial gain is strictly forbidden.Whilst further distribution of specific materials from within this archive is forbidden, you may freely distribute the URL of WestminsterResearch.(http://www.wmin.ac.uk/westminsterresearch).In case of abuse or copyright appearing without permission e-mail wattsn@wmin.ac.uk. Abstract: C-reactive protein (CRP) has received much attention as a cardiovascular risk factor and has been recommended to be used in screening to assist in predicting the occurrence of cardiovascular disorders. There are numerous association studies documenting changes in circulating CRP concentrations, there are, however, fewer studies providing evidence that CRP mediates the progression of cardiovascular pathologies. Elucidating the potential mechanisms for CRP has been confounded by recent reports that contaminants of CRP are partially responsible for observed effects.In this review the use of CRP as a tool to predict cardiovascular disorders will be discussed alongside a more recently described cardiovascular risk factor asymmetric dimethylarginine (ADMA). An endogenously occurring nitric oxide synthase inhibitor, ADMA, is formed by the action of protein arginine methyltransferases and subsequent proteolysis and it is metabolised in vivo by the dimethylarginine dimethylaminohydrolases (DDAH). The evidence available documenting the effects of CRP and ADMA, the regulatory mechanisms and the genetic influences, will be discussed in order to determine whether CRP and ADMA are mediators in the progression of cardiovascular disorders or merely useful biomarkers.

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Left ventricular hypertrophy, cardiac remodeling and asymmetric dimethylarginine (ADMA) in hemodialysis patients

Abstract: Overall, this study indicates that raised plasma concentration of ADMA is associated to concentric LVH and LV dysfunction. Intervention studies are needed to see whether the link between ADMA and concentric LVH remodeling and LV dysfunction is a causal one.

Cited by 198 publications

References 36 publications

The Relationship among Asymmetric Dimethylarginine (ADMA) Levels, Residual Renal Function, and Left Ventricular Hypertrophy in Continuous Ambulatory Peritoneal Dialysis Patients

The Relationship among Asymmetric Dimethylarginine (ADMA) Levels, Residual Renal Function, and Left Ventricular Hypertrophy in Continuous Ambulatory Peritoneal Dialysis Patients

Asymmetric Dimethylarginine and Clinical Outcomes in Chronic Kidney Disease

C-Reactive Protein and Asymmetric Dimethylarginine: Markers or Mediators in Cardiovascular Disorders?

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