title: Association between brachial-ankle pulse wave velocity and the ratio of l-arginine to asymmetric dimethylarginine in patients undergoing coronary angiography.
abstract: BACKGROUND
  Endothelial dysfunction causes vasomotor dysregulation and vascular stiffening in addition to structural changes. By influencing NO synthesis, deficiency of l-arginine relative to asymmetric dimethylarginine (ADMA), which is an l-arginine derivative that acts as a competitive NO synthase inhibitor, may lead to the promotion of arterial stiffness. This study investigated the relationship between the l-arginine/ADMA ratio and brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness.
  
  
  RESULTS
  This cross-sectional study enrolled 74 patients (62 men, 12 women; mean age, 67±10 years) undergoing elective coronary angiography. A total of 54 (73%) patients had coronary artery disease. Serum l-arginine and ADMA were measured by high-performance liquid chromatography with fluorescence detection. The ratio of l-arginine to ADMA and the serum l-arginine level was associated with baPWV in univariate regression analysis (l-arginine/ADMA ratio: β=-0.323, p=0.005; l-arginine: β=-0.247, p=0.034). In addition, baPWV was related to blood hemoglobin concentration, hematocrit, brain natriuretic peptide level, symmetric dimethylarginine, renal function, blood pressure, and heart rate. In multivariate analysis, the l-arginine/ADMA ratio was a significant predictor of baPWV (β=-0.310, p<0.001). In subgroup analyses, the l-arginine/ADMA ratio was associated with baPWV in elderly patients (n=46, β=-0.359, p=0.004), and in younger patients (n=28, β=-0.412, p=0.006).
  
  
  CONCLUSIONS
  A low l-arginine/ADMA ratio may be associated with high baPWV in patients undergoing coronary angiography.
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan. Electronic address: masakinobuyuki@hotmail.com.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Masaki
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Daihiko
authors.initials: D
authors.lastname: Hakuno
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Toya
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Yasunaga
authors.initials: Y
authors.lastname: Shiraishi
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Kujiraoka
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Namba
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Yada
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Miyazaki
authors.affiliation: Department of Cardiovascular Medicine, National Defense Medical College, Tokorozawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Adachi
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood* / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D017023:Coronary Angiography / Q000187:drug effects*; D003324:Coronary Artery Disease / Q000097:blood / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006400:Hematocrit; D006454:Hemoglobins / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000187:drug effects; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness / Q000187:drug effects
chemical_list: D006454:Hemoglobins; D020097:Natriuretic Peptide, Brain; C024917:symmetric dimethylarginine; C018524:N,N-dimethylarginine; D001120:Arginine
keywords: Asymmetric dimethylarginine; Brachial-ankle pulse wave velocity; Nitric oxide