Akut pulmoner tromboemboli̇de plazma asi̇metri̇k di̇meti̇larji̇ni̇n düzeyi̇ni̇n tani ve taki̇pteki̇ yeri̇

Pulmonary embolism, as a pulmonary artery and / or branches of the system caused by venous occlusion with thrombus, the diagnosis of diffucult, a high mortality of cardiovascular disease. ADMA is competitive inhibitor of endothelial nitric oxide synthatase so plays a regulatory role in the formation of endothelial nitric oxide. The main mechanisms of nitric oxide involved in ınhibition of proliferation of smooth muscle cells, endothelium derived vasodilatation, in blood vessels cell-cell interaction (platalet adhesion / aggregation and inhibition of monocyte adhesion). Hypercoagulability, endothelial damage and stasis are known to play role in pathophysiology of pulmonary thromboembolism. Pathophysiology of nitric oxide in the relationship with the mechanisms of ADMA considering the diagnosis and follow-up of pulmonary tromboembilism may be a place. 30 patients with acute pulmonary thromboembolism and 20 healthy volunteers were taken in our study. Patients were followed 1 month. Plasma ADMA levels were measured on admission and first month. Patients with pulmonary thromboembolism, perfermed computed tomographic angiography, made of echocardiography, and arterial blood gas or pulse oximetry was evaluated with the status of hypoxemia on admission and firsth month. The presenting value of the ADMA is significantly higher in pulmoner thromboemboli group while compared to control group; yet again a significant increase in the rate of ADMA is determined in 1st month control values compared to presenting values in pulmoner thromboemboli group. The presenting value of ADMA and PABTOIO ,the trombus load determinant , showed a negative correlation with the partial oxygen pressure measured in the arterial blood gas test and a positive correlation with the estimated pulmonary artery systolic pressure and right ventricular systolic dysfunction degree. The change in the ADMA (Δ) during one month follow- up was positively correlated with PABTOIO and presenting right ventricular systolic dysfunction degree. Altough there is a significant correlation between the presenting value of the ADMA and the partial oxygen pressure, during the follow-up, lacking of this correlation was thought to be due to recovery from hypoxemia. These data suggest that ADMA is a useful marker for diagnosis and treatement.