Asymmetrical dimethylarginine--more sensitive than NT-proBNP to diagnose heart failure in adults with congenital heart disease.

Abstract

BACKGROUND:

Chronic heart failure is an important cause for morbidity and mortality in adults with congenital heart disease (ACHD). While NT-proBNP is an established biomarker for heart failure of non-congenital origin, its value in ACHD has limitations. Asymmetrical dimethylarginine (ADMA) correlates with disease severity and independently predicts adverse clinical events in heart failure of non-congenital origin. Its role in ACHD has not been investigated.

METHODS:

In 102 patients ADMA and NT-proBNP were measured and related to NYHA class, systemic ventricular function and parameters of cardiopulmonary exercise testing.

RESULTS:

In contrast to NT-proBNP ADMA differentiated between NYHA classes I-III. Both, ADMA and NT-proBNP showed a good correlation with parameters of cardiopulmonary exercise testing with comparable receiver-operating characteristic curves for identifying patients with severely limited cardiopulmonary exercise capacity.

CONCLUSION:

ADMA seems to be a better biomarker than NT-proBNP for the assessment of NYHA class and as a good as NT-proBNP for the estimation of maximum exercise capacity in adults with congenital heart disease. Its use in clinical routine should be evaluated.

• Authors: Oktay Tutarel, Agnieszka Denecke, Stefanie M Bode-Böger, Jens Martens-Lobenhoffer, Svjetlana Lovric, Johann Bauersachs, Bernhard Schieffer, Mechthild Westhoff-Bleck, Jan T Kielstein
• Journal: PloS one (PLoS One) Vol. 7 Issue 3 Pg. e33795 ( 2012) ISSN: 1932-6203 [Electronic] United States
• PMID: 22470476 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Peptide Fragments
• dimethylarginine
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain
• Arginine

Topics

• Adult
• Arginine (analogs & derivatives, blood)
• Biomarkers (blood)
• Cross-Sectional Studies
• Echocardiography
• Exercise Test
• Female
• Heart Defects, Congenital (complications)
• Heart Failure (complications, diagnosis, mortality)
• Humans
• Male
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• ROC Curve
• Ventricular Dysfunction, Left
• Young Adult