Saitoh Masayuki, Osanai Tomohiro, Kamada Takaatsu, Matsunaga Toshiro, Ishizaka Hiroshi, Hanada Hiroyuki, Okumura Ken
Second Department of Internal Medicine, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan.
Heart Vessels. 2003 Sep;18(4):177-82. doi: 10.1007/s00380-003-0715-y.
Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, is elevated in congestive heart failure (CHF) concomitantly with the higher levels of nitric oxide (NO) and cytokines. We investigated the association among ADMA, NO, and cytokines in human CHF. Blood was collected from 25 patients with acutely exacerbated chronic CHF (acute CHF, mean age 61 +/- 3 years), 23 patients with chronic compensated CHF (chronic CHF, mean age 62 +/- 2 years), and 26 control subjects (mean age 51 +/- 1 years). ADMA was measured by high-performance liquid chromatography. Tumor necrosis factor-alpha (TNF-alpha) was measured by enzyme-linked immunosorbent assay. Nitrate plus nitrite (NOx) was measured by the Griess method. The plasma levels of ADMA and TNF-Alpha were higher in patients with acute CHF than in those with chronic CHF and control subjects (both P < 0.05). The plasma level of NOx was higher in patients with chronic CHF than in those with acute CHF and control subjects (both P < 0.01). The plasma level of TNF-Alpha was positively correlated with that of ADMA in combination with patients with acute and chronic CHF (r = 0.31, P < 0.01). The plasma level of ADMA was, furthermore, negatively correlated with that of NOx (r = -0.29, P < 0.05). These findings indicate that ADMA is related to exacerbation of chronic CHF by suppression of the compensatory higher level of plasma NO.
不对称二甲基精氨酸（ADMA）是一氧化氮合酶的内源性抑制剂，在充血性心力衰竭（CHF）中升高，同时伴有较高水平的一氧化氮（NO）和细胞因子。我们研究了人类CHF中ADMA、NO和细胞因子之间的关联。收集了25例急性加重的慢性CHF患者（急性CHF，平均年龄61±3岁）、23例慢性代偿性CHF患者（慢性CHF，平均年龄62±2岁）和26例对照者（平均年龄51±1岁）的血液。通过高效液相色谱法测定ADMA。通过酶联免疫吸附测定法测定肿瘤坏死因子-α（TNF-α）。通过格里斯方法测定硝酸盐加亚硝酸盐（NOx）。急性CHF患者的血浆ADMA和TNF-α水平高于慢性CHF患者和对照者（均P<0.05）。慢性CHF患者的血浆NOx水平高于急性CHF患者和对照者（均P<0.01）。急性和慢性CHF患者联合起来，血浆TNF-α水平与ADMA水平呈正相关（r=0.31，P<0.01）。此外，血浆ADMA水平与NOx水平呈负相关（r=-0.29，P<0.05）。这些发现表明，ADMA通过抑制代偿性较高水平的血浆NO与慢性CHF的加重有关。
