title: ADMA correlates with portal pressure in patients with compensated cirrhosis.
abstract: BACKGROUND
  Chronic liver diseases are frequently complicated by portal hypertension, an important component of which is the increased intrahepatic vascular resistance, in part related to endothelial dysfunction. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase, is an established mediator and marker of endothelial dysfunction. We therefore investigated the possible implication of ADMA in chronic liver diseases-induced portal hypertension.
  
  
  METHODS
  We studied 39 consecutive patients with compensated hepatitis C virus (HCV) related chronic liver diseases. All patients underwent hepatic venous pressure gradient (HVPG) measurement, and simultaneous blood sampling from the hepatic vein and the pulmonary artery, for ADMA and nitrite/nitrate (NOx) plasma level determinations.
  
  
  RESULTS
  A positive correlation between HVPG and ADMA concentrations in hepatic veins (ADMA-h) was found (r = 0.77, P < 0.0001). Moreover, a negative correlation between HVPG and NOx concentrations in the hepatic veins (NO-h) (r = -0.50, P = 0.005), and between ADMA-h and NO-h was observed (r = -0.40, P = 0.02). ADMA concentrations in pulmonary artery (ADMA-p) (0.55 +/- 0.13 micromol L(-1)) were significantly higher than in hepatic veins (0.47 +/- 0.09 micromol L(-1)) (P < 0.0001).
  
  
  CONCLUSIONS
  These results suggest that ADMA may play a pathophysiological role in portal hypertension by contributing to the relative intrahepatic NO deficiency typical of endothelial dysfunction.
authors.affiliation: Dipartimento di Medicina Interna, Università degli Studi di Firenze, Florence, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Vizzutti
authors.forename: R G
authors.initials: RG
authors.lastname: Romanelli
authors.forename: U
authors.initials: U
authors.lastname: Arena
authors.forename: L
authors.initials: L
authors.lastname: Rega
authors.forename: M
authors.initials: M
authors.lastname: Brogi
authors.forename: C
authors.initials: C
authors.lastname: Calabresi
authors.forename: E
authors.initials: E
authors.lastname: Masini
authors.forename: R
authors.initials: R
authors.lastname: Tarquini
authors.forename: M
authors.initials: M
authors.lastname: Zipoli
authors.forename: V
authors.initials: V
authors.lastname: Boddi
authors.forename: F
authors.initials: F
authors.lastname: Marra
authors.forename: G
authors.initials: G
authors.lastname: Laffi
authors.forename: M
authors.initials: M
authors.lastname: Pinzani
mesh_terms: D000328:Adult; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D017082:Portal Pressure / Q000502:physiology
chemical_list: D009569:Nitric Oxide; C018524:N,N-dimethylarginine; D001120:Arginine