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Serum ADMA concentration-- an independent factor determining FMD impairment in cardiac syndrome X

Maciej Haberka1, Katarzyna Mizia-Stec, Zbigniew Gasior

  • 1Department of Cardiology, Medical University of Silesia, Katowice, Poland. mhaberka@op.pl

Upsala Journal of Medical Sciences
|December 8, 2009
PubMed

Insights

Endothelial dysfunction in Cardiac Syndrome X (CSX) is linked to impaired vascular reactivity. Asymmetric dimethylarginine (ADMA) is the sole independent factor identified as causing flow-mediated vasodilatation (FMD) impairment in CSX patients.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Biochemistry

Background:

  • Cardiac Syndrome X (CSX) is characterized by chest pain despite normal coronary angiograms.
  • The precise mechanisms underlying reduced endogenous vascular reactivity in CSX remain unclear.
  • Endothelial dysfunction is a suspected contributor to CSX pathophysiology.

Purpose of the Study:

  • To investigate serum markers including total nitric oxide (NO), asymmetric dimethylarginine (ADMA), and platelet-derived growth factor (PDGF) in CSX patients.
  • To determine the relationship between these serum markers and ultrasound-assessed endothelial function and vascular remodeling.
  • To identify key factors contributing to impaired vascular reactivity in CSX.

Main Methods:

  • A case-control study involving 43 CSX patients and 21 healthy controls.
  • High-resolution ultrasound was used to measure flow-mediated vasodilatation (FMD), nitroglycerine-mediated vasodilatation (NMD), and intima-media thickness (IMT) of carotid arteries.
  • Serum levels of total NO, ADMA, and PDGF were quantified and analyzed.

Main Results:

  • CSX patients exhibited significantly lower FMD and higher IMT compared to controls (P < 0.05).
  • Mean serum total NO levels were significantly higher in CSX patients than in controls (P < 0.0001).
  • Serum ADMA concentration was identified as the independent factor significantly associated with FMD impairment in CSX patients.

Conclusions:

  • Asymmetric dimethylarginine (ADMA) is the primary independent determinant of impaired flow-mediated vasodilatation (FMD) in patients with Cardiac Syndrome X (CSX).
  • While total nitric oxide (NO) levels were elevated in CSX, ADMA emerged as the critical factor for endothelial dysfunction.
  • These findings highlight the role of ADMA in the vascular abnormalities observed in CSX.
Abstract

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