1Cardiology Care Unit, San Camillo de Lellis Hospital, Manfredonia, Foggia, Italy, 2Clinical Biochemistry, Department of Biomedical Science, G. D’Annunzio, University of Chieti, Italy, 3Department of Internal Medicine and Aging Science, University G. D’Annunzio, Chieti, Italy
TABLE OF CONTENTS
- 1. Abstract
- 2. Introduction
- 2.1. Study design
- 2.2. Patients
- 2.3. Sample collection, storage and preparation
- 2.4. Biochemical analysis
- 2.5. Physical exercise
- 2.6. Statistical analysis
- 3. Results
- 3.1. Characteristic of subjects
- 4. Discussion
- 5. References
Increased levels of asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) and low plasma level of L-arginine (L-ARG) are all conditions likely to decrease nitric oxide (NO) production. Aim of this study is to evaluate ADMA, SDMA, and L-ARG plasmatic levels before and after physical exercise in patients with coronary artery disease (CAD). We studied 30 patient with mean age 52 ± 4.5 years. After inclusion in the study, before the execution of physical exercise, heparinized blood sample was drawn from an indwelling arterial line for determination of ADMA, L-ARG and SDMA (baseline values). Subsequently a blood sample was drawn after the physical exercise. The mean plasma concentrations of ADMA (0.68 0.06 vs 0.48 ± 0.05 mol/L) and SDMA (0.45 ± 0.03 vs 0.30 ± 0.03 ýmol/L) were significantly lower after physical exercise in comparison to baseline value, while L-ARG mean levels were increased (44.20 ± 10.5 vs 74.13 ± 11.2 ýmol/L). Physical exercise has a beneficial effect by reducing plasmatic ADMA and SDMA levels, and increasing L-ARG substrate for endothelial NO.
1. T Heitzer, T Schlinzig, K Krohn, T Meinertz, T Munzel: Endothelial dysfunction, oxidative stress, and risk of cardiovascular events in patients with coronary artery disease.
2. S Moncada, EA Higgs: The discovery of nitric oxide and its role in vascular biology.
3. D Tousoulis, AM Kampoli, C Tentolouris, N Papageorgiou, C Stefanadis: The role of nitric oxide on endothelial function.
4. S Blackwell: The biochemistry, measurement and current clinical significance of asymmetric dimethylarginine.
6. RH Boger, LM Sullivan, E Schwedhelm, TJ Wang, R Maas, EJ Benjamin, F Schulze, V Xanthakis, RA Benndorf, RS Vasan: Plasma Asymmetric Dimethylarginine and Incidence of Cardiovascular Disease and Death in the Community.
7. K Hanai, T Babazono, I Nyumura, K Toya, N Tanaka, M Tanaka, A Ishii, Y Iwamoto: Asymmetric dimethylarginine is closely associated with the development and progression of nephropathy in patients with type 2 diabetes.
8. RH Böger, R Maas, F Schulze, E Schwedhelm: Asymmetric dimethylarginine (ADMA) as a prospective marker of cardiovascular disease and mortality.. an update on patient populations with a wide range of cardiovascular risk.
9. TM Lu, YA Ding, SJ Lin, WS Lee, HC Tai: Plasma levels of asymmetrical dimethylarginine and adverse cardiovascular events after percutaneous coronary intervention.
Doi: 10.1016/j.ehj.2003.08.013 PMid:14585249
11. S Gielen, G Schuler, V Adams: Cardiovascular effects of exercise training: molecular mechanisms.
12. P Kokkinos, J Myers, JP Kokkinos, A Pittaras, P Narayan, A Manolis, P Karasik, M Greenberg, V Papademetriou, S Singh, Exercise capacity and mortality in black and white men.
Doi: 10.1161/CIRCULATIONAHA.107.734764 PMid:18212278
13. JE Manson, P Greenland, AZ LaCroix, ML Stefanick, CP Mouton, A Oberman, MG Perri, DS Sheps, M Pettinger, DS Siscovick: Walking compared with vigorous exercise for the prevention of cardiovascular events in women.
Doi: 10.1056/NEJMoa021067 PMid:12213942
14. T Teerlink, RJ Nijveldt, S de Jong, PA van Leeuwen: Determination of Arginine, Asymmetric Dimethylarginine, and Symmetric Dimethylarginine in Human Plasma and Other Biological Samples by High. Performance Liquid Chromatography.
15. BJ Maron, PD Thompson, MJ Ackerman, G Balady, S Berger, D Cohen, R Dimeff, PS Douglas, DH Glover, AM Hutter, MD Jr., Krauss, MS Maron, MJ Mitten, WO Roberts, JC Puffer: American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Recommendations and considerations related to pre. participation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association 16. Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation.
16. PD Thompson, D Buchner, IL Pina, GJ Balady, MA Williams, BH Marcus, K Berra, SN Blair, F Costa, B Franklin, GF Fletcher, NF Gordon, RR Pate, BL Rodriguez, AK Yancey, NK Wenger, American Heart Association Council on Clinical Cardiology Subcommittee on Exercise, Rehabilitation, and Prevention, American Heart Association Council on Nutrition, Physical Activity, and Metabolism Subcommittee on Physical Activity. Exercise and physical activity in the prevention an treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity)
17. N Jairath: Implications of gender differences on coronary artery disease risk reduction in women.
18. EB Beck, S Erbs, S Möbius. Winkler, V Adams, FJ Woitek, T Walther, R Hambrecht, FW Mohr, M Stumvoll, M Blüher, G Schuler, A Linke: Exercise training restores the endothelial response to vascular growth factors in patients with stable coronary artery disease.
19. HS Dod, R Bhardwaj, V Sajja, G Weidner, GR Hobbs, GW Konat, S Manivannan, W Sharib, BE Warden, NC Nanda, BJ Beto, D Ornish, AC Jain: Effect of intensive lifestyle changes on endothelial function and on inflammatory markers of atherosclerosis.
20. MH Laughlin, DK Bowles, DJ Duncker: The coronary circulation in exercise training.
21. C Walther, S Gielen, R Hambrecht: The effect of exercise training on endothelial function in cardiovascular disease in humans.
22. S Möbius. Winkler, A Linke, V Adams, G Schuler, S Erbs: How to improve endothelial repair mechanisms: the lifestyle approach.
23. Djordjevic, D., Jakovljevic, V., Cubrilo. D., Zlatkovic, M., Zivkovic, V., Djuric, D. : Coordination between nitric oxide and superoxide anion radical during progressive exercise in elite soccer players. Open.
24. F Ribeiro, AJ Alves, JA Duarte, J Oliveira: Is exercise training an effective therapy targeting endothelial dysfunction and vascular wall inflammation?
25. H Matsuoka, S Itoh, M Kimoto, K Kohno, O Tamai, Y Wada, H Yasukawa, G Iwami, S Okuda, T Imaizumi: Asymmetrical dimethylarginine, an endogenous nitric oxide synthase inhibitor, in experimental hypertension.
26. H Miyazaki, H Matsuoka, JP Cooke, M Usui, S Ueda, S Okuda, T Imaizumi: Endogenous nitric oxide synthase inhibitor: a novel marker of atherosclerosis.
27. A Pandolfi, A Grilli, C Cilli, A Patruno, A Giaccari, S Di Silvestre, MA De Lutiis, G Pellegrini, F Capani, A Consoli, M Felaco: Phenotype modulation in cultures of vascular smooth muscle cells from diabetic rats: association with increased nitric oxide synthase expression and superoxide anion generation.
28. JJ Whyte, MH Laughlin: The effects of acute and chronic exercise on the vasculature.
29. DA Leaf, MT Kleinman, M Hamilton, RW Deitrick: The exercise. induced oxidative stress paradox: the effects of physical exercise training.
30. AJ Cardounel, Y Xia, JL Zweier: Different effects of endogenous nitric oxide synthase inhibitors on nitric oxide and superoxide production.
31. N Sen, MF Ozlu, EO Akgul, S Kanat, T Cayci, O Turak, H Yaman, E Sokmen, F Ozcan, O Maden, AD Demir, A Covic, M Kanbay: Elevated plasma asymmetric dimethylarginine level in acute myocardial infarction patients as a predictor of poor prognosis and angiographic impaired reperfusion.
32. L Sibal, SC Agarwal, PD Home, RH Boger: The Role of Asymmetric Dimethylarginine (ADMA) in Endothelial Dysfunction and Cardiovascular Disease.
33. J Leiper, P Vallance: Biological significance of endogenous methylarginines that inhibit nitric oxide synthases.
34. E Schepers, G Glorieux, A Dhondt, L Leybaert, R Vanholder: Role of symmetric dimethylarginine in vascular damage by increasing ROS via store. operated calcium influx in monocytes.
35. G Riccioni, L Speranza, L Scotti, V Bucciarelli, E Di Ilio, N D’Orazio, M Pesce, A Aceto, V Sorrenti, A Frigiola, T Bucciarelli: The effect of pharmacological treatment on ADMA in patients with heart failure.
36. G Riccioni, V Bucciarelli, L Scotti, A Aceto, N D’Orazio, E Di Ilio, T Bucciarelli: Relationship between asymmetric dimethylarginine and asymptomatic carotid atherosclerosis.
37. JT Kielstein, C Zoccali: Asymmetric dimethylarginine: a cardiovascular risk factor and a uremic toxin coming of age?
38. P Vallance, A Leone, A Calver, J Collier, S Moncada: Accumulation of an endogenous inhibitor of nitric oxide synthesis in chronic renal failure.
39. C Fleck, F Schweitzer, E Karge, M Busch, G Stein: Serum concentrations of asymmetric (ADMA) and symmetric (SDMA) dimethylarginine in patients with chronic kidney diseases.
Key Words: ADMA, SDMA L-arginine, Nitric Oxide; Coronary Artery Disease, Physical Exercise
Send correspondence to: Graziano Riccioni, Intensive Cardiology Care Unit, San Camillo de Lellis Hospital, 71043 Manfredonia, Foggia, Italy, Tel: 39-0884-510470, Fax: 39-0882-227022, E-mail: griccionI@hotmail.com