title: Relation of asymmetric dimethylarginine and cardiac involvement in systemıc sclerosis.
abstract: OBJECTIVE
  The heart is a commonly involved organ in systemic sclerosis (SSc) and pulmonary hypertension is a commonly observed complication that is associated with poor prognosis in this disease. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthases. In this study, we aimed to contribute to an early diagnosis of cardiac involvement by evaluating ADMA and tissue Doppler electrocardiographic findings in patients with SSc.
  
  
  METHODS
  30 SSc patients without clinical cardiac symptoms and 30 controls were included. Plasma ADMA levels were measured and tissue Doppler electrocardiography examination was carried out for all participants. Systolic and diastolic functions were assessed; pulmonary arterial systolic pressure and mean pulmonary arterial pressure were measured.
  
  
  RESULTS
  The patient and control groups demonstrated a significant difference with regard to right ventricular free wall tissue Doppler late diastolic wave, pulmonary arterial systolic pressure, right ventricular ejection fraction, and right ventricular diastolic dysfunction values. ADMA levels were significantly higher in SSc patients and also in active patients compared to inactive patients. No significant relationship between ADMA and echocardiographic parameters was found.
  
  
  CONCLUSIONS
  Tissue Doppler echocardiography is capable of revealing impaired right ventricular functions and increased pulmonary arterial systolic pressure before the occurrence of any cardiac clinical symptoms in patients with SSc. Serum ADMA levels were increased in SSc and in patients with active disease.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Şevin
authors.initials: Ş
authors.lastname: Dağ
authors.affiliation: Department of Physical Medicine and Rehabilitation, Bismil State Hospital, Diyarbakir, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Budulgan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dokuz Eylul University Hospital, İzmir, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Dilek
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dicle University Hospital,Diyarbakır, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Batmaz
authors.affiliation: Department of Cardiology, Dicle University Hospital, Diyarbakir, Turkey.
authors.forename: Z
authors.initials: Z
authors.lastname: Arıtürk
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dicle University Hospital, Diyarbakır, Turkey.
authors.forename: K
authors.initials: K
authors.lastname: Nas
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dicle University Hospital, Diyarbakır, Turkey.
authors.forename: R
authors.initials: R
authors.lastname: Çevik
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D016022:Case-Control Studies; D042241:Early Diagnosis; D015150:Echocardiography, Doppler; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D012595:Scleroderma, Systemic / Q000097:blood* / Q000150:complications*
chemical_list: C018524:N,N-dimethylarginine; D001120:Arginine