Vol 75, No 10 (2017)
Original articles
Published online: 2017-06-28

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Increased plasma asymmetric dimethylarginine level is associated with ascending aorta dilatation: a case-control study

Muhammet Hulusi Satılmışoğlu, Vesile Örnek Diker1, Ömer Taşbulak2, Mustafa Diker3, Ali Birand4, Mehmet Kaya5, Taner İyigün5, Abdurrahman Eksik2
Kardiol Pol 2017;75(10):1020-1026.

Abstract

Background: Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase.

Aim: We aimed to determine plasma ADMA levels in patients with ascending aorta dilatation in comparison to those without aorta dilatation, and to evaluate the diagnostic, predictive, and prognostic value of serum ADMA level for aorta dilatation.

Methods: This was a cross-sectional case-control study. A total of 104 consecutive patients (female/male, 35/69; mean age, 62.75 ± 13.11 years) diagnosed with ascending aorta dilatation (≥ 4.5 cm) on echocardiography (case group), and 52 age-and gender-matched patients (female/male, 17/35; mean age, 63.44 ± 7.56 years) with normal aorta dimensions (≤ 3.8 cm) (control group) were included. Routine biochemical and haematological analysis in addition to measurement of serum ADMA level were performed.

Results: The mean diameter of ascending aorta measured on echocardiography was 4.95 ± 0.57 cm and 3.34 ± 0.36 cm in patients with aorta dilatation and those without aorta dilatation, respectively (p < 0.001). Serum ADMA level was significantly higher in patients with aorta dilatation than in the control group (1.70 ± 1.12 μmol/L vs. 0.79 ± 0.76 μmol/L, respectively, p < 0.001). There was significant positive correlation between ADMA level and aortic diameter in Spearman correlation analysis (r = 0.317, p < 0.001). In linear regression analysis, ADMA was found to be a significant independent predictor of aorta diameter (Beta = 0.26, p < 0.001). Receiver-operator characteristic curve analysis also revealed that serum ADMA cut-off level over 0.29 μmol/L predicts aorta dilatation (≥ 4.5 cm) with 94% sensitivity and 92% specificity and with high ac­curacy (area under curve: 0.786; 95% confidence interval: 0.709–0.863, p < 0.001).

Conclusions: Serum ADMA level is diagnostic for ascending aorta dilatation with high sensitivity and specificity, and should be considered for use in clinical diagnosis of aorta dilatation.  

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Polish Heart Journal (Kardiologia Polska)