title: Asymmetric dimethylarginine and vascular indices of atherosclerosis in patients after coarctation of aorta repair.
abstract: OBJECTIVE
  Cardiovascular events are the main cause of premature death after successful repair of aortic coarctation (CoA). The aim of this study was to assess the selected biochemical markers of atherosclerosis in normotensive CoA repaired patients and to establish its relation to ultrasound indexes of vascular pathology.
  
  
  METHODS
  62 patients after CoA repair (37 males, age: 34.1 ± 1.4 yrs) and 20 control individuals (10 males, age: 34.8 ± 2.2 yrs) were enrolled in the study. The serum markers: asymmetric dimethylarginine (ADMA), nitrites/nitrates (NOx), high-sensitivity C-reactive protein (hsCRP), and following vascular parameters: flow-mediated dilatation (FMD), intima-media thickness (IMT) and pulse wave velocity (PWV) were analyzed.
  
  
  RESULTS
  33 CoA repaired patients were normotensive, and compared to controls, they presented higher serum ADMA concentrations (0.59 ± 0.04 umol/l vs. 0.46 ± 0.03 umol/l, p=0.035). An analysis of the vascular parameters revealed decreased FMD (4.75 ± 0.5%), NMD (11.86 ± 0.8%) and increased PWV (6.90 ± 0.2 m/s) values in the normotensive patients as compared with the control group (FMD: 8.6 ± 0.9%, p<0.001, NMD: 20.94 ± 1.7%, p<0.001; PWV: 5.49 ± 0.2, p=0.023). There were no differences in the serum levels of NOx, hsCRP as well as IMT values between normotensive patients and the control group. A multivariate regression analysis revealed that serum ADMA level was a factor independently associated with the FMD value (r=-0.334; p=0.031) in normotensive CoA repaired group.
  
  
  CONCLUSIONS
  Early biochemical and vascular indices of atherosclerosis such as increased serum ADMA concentration as well as impaired vasodilatation and increased arterial stiffness are observed in patients after CoA repair. Serum ADMA is a strong predictor of endothelial dysfunction in patients with CoA repair.
authors.affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland. kmizia@op.pl
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Mizia-Stec
authors.forename: Olga
authors.initials: O
authors.lastname: Trojnarska
authors.forename: Ludwina
authors.initials: L
authors.lastname: Szczepaniak-Chicheł
authors.forename: Marcin
authors.initials: M
authors.lastname: Gabriel
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Bartczak
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Ciepłucha
authors.forename: Jerzy
authors.initials: J
authors.lastname: Chudek
authors.forename: Stefan
authors.initials: S
authors.lastname: Grajek
authors.forename: Andrzej
authors.initials: A
authors.lastname: Tykarski
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Gąsior
mesh_terms: D000328:Adult; D001017:Aortic Coarctation / Q000601:surgery*; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D006348:Cardiac Surgical Procedures; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D008297:Male; D009566:Nitrates / Q000097:blood; D009573:Nitrites / Q000097:blood; D011183:Postoperative Complications / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011673:Pulsatile Flow / Q000502:physiology; D059289:Vascular Stiffness / Q000502:physiology; D014664:Vasodilation / Q000502:physiology
chemical_list: D015415:Biomarkers; D009566:Nitrates; D009573:Nitrites; C018524:N,N-dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine