title: Determinants of circulating asymmetric and symmetric dimethylarginines in patients evaluated for acute dyspnea.
abstract: BACKGROUND
  The relationship between asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) plasma concentrations and acute heart failure is unknown. We evaluated ADMA and SDMA in patients with acute dyspnea.
  
  
  METHODS
  We studied 57 dyspneic subjects (50-95 years), with estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m², presenting to the emergency department. Troponin I, N terminal-proBNP (NT-proBNP), ADMA, and SDMA were measured. Electrocardiogram, chest X-ray and lung ultrasound were performed. Patients were classified into cardiogenic dyspnea and non-cardiogenic dyspnea, and were also classified on the basis of renal function according to their eGFR.
  
  
  RESULTS
  Two-way analysis of variance demonstrated that ADMA and SDMA did not differ for type of dyspnea, but increased in renal dysfunction. NT-proBNP significantly increased both in cardiogenic dyspnea and renal dysfunction. Multiple regression analysis demonstrated that after adjustment for troponin and dyspnea, the only variables which significantly correlated with SDMA plasma concentrations were renal function (β = -0.47, p < 0.001) and NT-proBNP (β = 0.28, p = 0.02).
  
  
  CONCLUSIONS
  Neither type of dimethylarginine showed cardiogenic dyspnea to be a determinant for plasma concentrations. Renal dysfunction was a confounder for both ADMA and SDMA.
authors.affiliation: Department of Medical and Surgical Sciences, University of Padova, Padova, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Codognotto
authors.forename: Antonio
authors.initials: A
authors.lastname: Piccoli
authors.forename: Camilla
authors.initials: C
authors.lastname: Rubini
authors.forename: Vito
authors.initials: V
authors.lastname: Cianci
authors.forename: Gianna
authors.initials: G
authors.lastname: Vettore
authors.forename: Monica M
authors.initials: MM
authors.lastname: Mion
authors.forename: Carlo
authors.initials: C
authors.lastname: Artusi
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood / Q000737:chemistry; D015415:Biomarkers / Q000097:blood; D004417:Dyspnea / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D012044:Regression Analysis
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C487735:dimethylarginine; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D001120:Arginine