Heart Institute, Faculty of Medicine, University of Pécs, H-7624 Pécs, Hungary.
Int J Mol Med. 2010 Apr;25(4):617-24. doi: 10.3892/ijmm_00000384.
The study was designed to compare the response pattern of plasma l-arginine and methylarginines to stent placement in patients with or without ST segment elevation myocardial infarction (STEMI). Two groups of patients with obstructive coronary artery disease (OCAD) undergoing percutaneous coronary intervention (PCI) with stenting were enrolled in the study. Group I consisted of 16 patients with STEMI, whereas group II included 24 patients without STEMI (controls). Before PCI and at <1 h, 5 and 30 days after reperfusion, blood samples were taken for measurement of l-arginine and methylarginines. L-arginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), N-monomethylarginine (MMA) and l-ornithine plasma levels were measured by LC-MS-MS. Arginine methylation index (Arg-MI) was calculated according to the formula, Arg-MI = (ADMA+SDMA)/MMA. In patients without STEMI, stenting induced a prompt and sustained depression of ADMA (p<0.000), and l-ornithine (p<0.000) with simultaneous increase of l-arginine (p<0.001), l-arginine/ADMA ratio (p<0.000) and an inconsistent change in MMA. Arg-MI remained at the baseline value. By contrast, STEMI patients responded to stent placement with a variable increase in l-arginine (p<0.01), ADMA (p<0.069), SDMA, MMA (p<0.01) and l-ornithine (p<0.000), whereas there was an early fall of Arg-MI after stenting, followed by a steady increase approaching the initial values. The differences in the time-course for ADMA (p<0.000), MMA (p<0.007), Arg-MI (p<0.01) and l-ornithine (p<0.003) proved to be significant between the STEMI and control group. It can be concluded therefore, that stent placement improves endothelial dysfunction in patients with OCAD when it is not complicated by STEMI.
本研究旨在比较经皮冠状动脉介入治疗（PCI）置入支架后伴有和不伴有 ST 段抬高型心肌梗死（STEMI）的患者血浆 l-精氨酸和甲基精氨酸的反应模式。该研究纳入了两组接受 PCI 置入支架治疗的阻塞性冠状动脉疾病（OCAD）患者。I 组包括 16 例 STEMI 患者，II 组包括 24 例无 STEMI（对照组）患者。在 PCI 术前和再灌注后<1 h、5 天和 30 天，采集血样以测量 l-精氨酸和甲基精氨酸。通过 LC-MS-MS 测定 l-精氨酸、非对称二甲基精氨酸（ADMA）、对称二甲基精氨酸（SDMA）、N-单甲基精氨酸（MMA）和 l-鸟氨酸的血浆水平。根据公式计算精氨酸甲基化指数（Arg-MI）：Arg-MI=（ADMA+SDMA）/MMA。在无 STEMI 的患者中，支架置入即刻并持续降低 ADMA（p<0.000）和 l-鸟氨酸（p<0.000），同时 l-精氨酸（p<0.001）、l-精氨酸/ADMA 比值（p<0.000）增加，MMA 变化不一致。Arg-MI 保持在基线值。相比之下，STEMI 患者对支架置入的反应是 l-精氨酸（p<0.01）、ADMA（p<0.069）、SDMA、MMA（p<0.01）和 l-鸟氨酸（p<0.000）的变化不一，支架置入后 Arg-MI 早期下降，随后稳定增加，接近初始值。ADMA（p<0.000）、MMA（p<0.007）、Arg-MI（p<0.01）和 l-鸟氨酸（p<0.003）的时间进程差异在 STEMI 组和对照组之间具有统计学意义。因此，可以得出结论，当 OCAD 不伴有 STEMI 时，支架置入可改善内皮功能障碍。
