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L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure

Methylated arginine metabolites interrupt nitric oxide synthesis, which can result in endothelium dysfunction and inadequate vasodilation. Since little is known about the dynamics of arginine derivatives in patients with heart failure (HF) during physical exercise, we aimed to determine this as well...

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Autores principales: Drohomirecka, Anna, Waś, Joanna, Wiligórska, Natalia, Rywik, Tomasz M., Komuda, Krzysztof, Sokołowska, Dorota, Lutyńska, Anna, Zieliński, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046255/
https://www.ncbi.nlm.nih.gov/pubmed/36979359
http://dx.doi.org/10.3390/biom13030423
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author Drohomirecka, Anna
Waś, Joanna
Wiligórska, Natalia
Rywik, Tomasz M.
Komuda, Krzysztof
Sokołowska, Dorota
Lutyńska, Anna
Zieliński, Tomasz
author_facet Drohomirecka, Anna
Waś, Joanna
Wiligórska, Natalia
Rywik, Tomasz M.
Komuda, Krzysztof
Sokołowska, Dorota
Lutyńska, Anna
Zieliński, Tomasz
author_sort Drohomirecka, Anna
collection PubMed
description Methylated arginine metabolites interrupt nitric oxide synthesis, which can result in endothelium dysfunction and inadequate vasodilation. Since little is known about the dynamics of arginine derivatives in patients with heart failure (HF) during physical exercise, we aimed to determine this as well as its impact on the patient outcomes. Fifty-one patients with HF (left ventricle ejection fraction-LVEF ≤ 35%, mean 21.7 ± 5.4%) underwent the cardiopulmonary exercise test (CPET). Plasma concentrations of L-arginine, citrulline, ornithine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) were measured before and directly after CPET. All patients were followed for a mean of 23.5 ± 12.6 months. The combined endpoint was: any death, urgent heart transplantation, or urgent LVAD implantation. L-arginine concentrations increased significantly after CPET (p = 0.02), when ADMA (p = 0.01) and SDMA (p = 0.0005) decreased. The parameters of better exercise capacity were positively correlated with post-CPET concentration of L-arginine and inversely with post-CPET changes in ADMA, SDMA, and baseline and post-CPET SDMA concentrations. Baseline and post-CPET SDMA concentrations increased the risk of endpoint occurrence (HR 1.02, 95% CI 1.009–1.03, p = 0.04 and HR 1.02, 95% CI 1.01–1.03, p = 0.02, respectively). In conclusion, in patients with HF, extensive exercise is accompanied by changes in arginine derivatives that can reflect endothelium function. These observations may contribute to the explanation of the pathophysiology of exercise intolerance in HF.
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spelling pubmed-100462552023-03-29 L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure Drohomirecka, Anna Waś, Joanna Wiligórska, Natalia Rywik, Tomasz M. Komuda, Krzysztof Sokołowska, Dorota Lutyńska, Anna Zieliński, Tomasz Biomolecules Article Methylated arginine metabolites interrupt nitric oxide synthesis, which can result in endothelium dysfunction and inadequate vasodilation. Since little is known about the dynamics of arginine derivatives in patients with heart failure (HF) during physical exercise, we aimed to determine this as well as its impact on the patient outcomes. Fifty-one patients with HF (left ventricle ejection fraction-LVEF ≤ 35%, mean 21.7 ± 5.4%) underwent the cardiopulmonary exercise test (CPET). Plasma concentrations of L-arginine, citrulline, ornithine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) were measured before and directly after CPET. All patients were followed for a mean of 23.5 ± 12.6 months. The combined endpoint was: any death, urgent heart transplantation, or urgent LVAD implantation. L-arginine concentrations increased significantly after CPET (p = 0.02), when ADMA (p = 0.01) and SDMA (p = 0.0005) decreased. The parameters of better exercise capacity were positively correlated with post-CPET concentration of L-arginine and inversely with post-CPET changes in ADMA, SDMA, and baseline and post-CPET SDMA concentrations. Baseline and post-CPET SDMA concentrations increased the risk of endpoint occurrence (HR 1.02, 95% CI 1.009–1.03, p = 0.04 and HR 1.02, 95% CI 1.01–1.03, p = 0.02, respectively). In conclusion, in patients with HF, extensive exercise is accompanied by changes in arginine derivatives that can reflect endothelium function. These observations may contribute to the explanation of the pathophysiology of exercise intolerance in HF. MDPI 2023-02-23 /pmc/articles/PMC10046255/ /pubmed/36979359 http://dx.doi.org/10.3390/biom13030423 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Drohomirecka, Anna
Waś, Joanna
Wiligórska, Natalia
Rywik, Tomasz M.
Komuda, Krzysztof
Sokołowska, Dorota
Lutyńska, Anna
Zieliński, Tomasz
L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure
title L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure
title_full L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure
title_fullStr L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure
title_full_unstemmed L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure
title_short L-arginine and Its Derivatives Correlate with Exercise Capacity in Patients with Advanced Heart Failure
title_sort l-arginine and its derivatives correlate with exercise capacity in patients with advanced heart failure
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046255/
https://www.ncbi.nlm.nih.gov/pubmed/36979359
http://dx.doi.org/10.3390/biom13030423
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