title: Asymmetrical dimethylarginine--more sensitive than NT-proBNP to diagnose heart failure in adults with congenital heart disease.
abstract: BACKGROUND
  Chronic heart failure is an important cause for morbidity and mortality in adults with congenital heart disease (ACHD). While NT-proBNP is an established biomarker for heart failure of non-congenital origin, its value in ACHD has limitations. Asymmetrical dimethylarginine (ADMA) correlates with disease severity and independently predicts adverse clinical events in heart failure of non-congenital origin. Its role in ACHD has not been investigated.
  
  
  METHODS
  In 102 patients ADMA and NT-proBNP were measured and related to NYHA class, systemic ventricular function and parameters of cardiopulmonary exercise testing.
  
  
  RESULTS
  In contrast to NT-proBNP ADMA differentiated between NYHA classes I-III. Both, ADMA and NT-proBNP showed a good correlation with parameters of cardiopulmonary exercise testing with comparable receiver-operating characteristic curves for identifying patients with severely limited cardiopulmonary exercise capacity.
  
  
  CONCLUSIONS
  ADMA seems to be a better biomarker than NT-proBNP for the assessment of NYHA class and as a good as NT-proBNP for the estimation of maximum exercise capacity in adults with congenital heart disease. Its use in clinical routine should be evaluated.
authors.affiliation: Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. otutarel@hotmail.com
authors.forename: Oktay
authors.initials: O
authors.lastname: Tutarel
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Denecke
authors.forename: Stefanie M
authors.initials: SM
authors.lastname: Bode-Böger
authors.forename: Jens
authors.initials: J
authors.lastname: Martens-Lobenhoffer
authors.forename: Svjetlana
authors.initials: S
authors.lastname: Lovric
authors.forename: Johann
authors.initials: J
authors.lastname: Bauersachs
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schieffer
authors.forename: Mechthild
authors.initials: M
authors.lastname: Westhoff-Bleck
authors.forename: Jan T
authors.initials: JT
authors.lastname: Kielstein
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012372:ROC Curve; D018487:Ventricular Dysfunction, Left; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C487735:dimethylarginine; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D001120:Arginine