ADMA and Heart failure

Heart failure incidence has doubled over the last decade and the occurrence of the heart failure mechanisms were not exactly understood.Endothelium-derived nitric oxide(NO) is the most potent endogenous vasodilator and by virtue of its anti-inflamatory and antitrombotic affects, it is an endogenous anti atherogenic agent. Accordingly impairment of no synthesis or bioactivity may increase the risk of Cardiovascular Disease.In endothelial cells Nitric Oxide is synthesized from the aminoacid Larginine by the action of the Nitric Oxide Synthase(NOS).Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of Nitric Oxide Synthase. This is an endogenous molecule which can be detected in human blood and urine. It shows structural homology to the aminoacid L- arginine.Elevated ADMA plasma levels have been reported in connection with diseases associated with an impaired endothelial L-arginine ?NO pathway and endothelial dysfunction such as Atherosclerosis, Chronic Heart Failure,Hypercholesterolemia, Diabetes Mellitus( DM) and Hypertension. There are two types of the heart failure. Systolic heart failure (EF <50%) and diastolic heart failure (EF> 50%). In recent years, the use of the plasma natriuretic peptides in the diagnosis of the heart failure was increased. Today pro-BNP which importance was understood recently, is significant for the diagnosis of the heart failure. BNP is the only specific natrüretik peptid for cardiac ventricles. Pro-BNP which is the precursor of BNP are deposited in the granules of myocytes.It is known that the potential importance of inflammatory mediators in the pathogenesis of the heart diseases.CRP is a beta- globulin and a highly sensitive non-specific inflammation, tissue damage and infection marker. In the studies about hs-CRP levels in patients with different etiologies of heart failure was found an increase of hs-CRP levels which was correlated with the complications.In our study, we investigated the difference between the serum levels of pro-BNP, hs-CRP and ADMA levels among the seventeen patients with systolic heart failure and the fifteen patients with diastolic heart failure.We found that pro-BNP, hs-CRP and ADMA levels were higher in patients with systolic heart failure and the difference between the two groups was statistically important.(p<0.05).