[Pathophysiological and clinical aspects of using L-arginine in cardiology and angiology]

Presented herein is a review of scientific publications dedicated to studying the pharmacodynamics of L-arginine and possibilities of its clinical application. Interest to L-arginine is associated, first of all, with its role as a precursor in endogenous synthesis of nitric oxide (NO), playing an important role in regulation of the functional state of the vascular wall. According to numerous studies, oral and parenteral administration of L-arginine restores endothelial production of NO in such diseases as atherosclerosis, hypertension, type 2 diabetes mellitus, obliterating diseases of arteries of lower extremities. The NO-mediated effect of L-arginine manifests itself in increasing the capability of vessels to dilatation, decreasing blood platelet aggregation, and inhibiting proliferation of smooth muscle cells of vessels. The effect is most pronounced in patients presenting with hypercholesterolaemia and initially decreased reactivity of the blood channel. The mostly pronounced NO-mediated effect of L-arginine is observed in parenteral route of its administration. Prolonged administration of L-arginine slows down progression of atherosclerosis.