Atıcı Adem, Aciksari Gonul, Baycan Omer Faruk, Barman Hasan Ali, Sonsöz Mehmet Rasih, Sahin Mustafa, Asoglu Ramazan, Demirkıran Ahmet, Kul Şeref, Gungor Baris, Durmaz Eser, Bilge Ahmet Kaya, Sahin Irfan
Cardiology Department, Istanbul Medeniyet University, Goztepe Training and Research Hospital, 34722 Istanbul, Turkey.
Cardiology Department, Okmeydani Training and Research Hospital, 34384 Istanbul, Turkey.
Medicina (Kaunas). 2019 Oct 29;55(11):718. doi: 10.3390/medicina55110718.
: Vasovagal syncope (VVS) is the most common cause of syncope and has multiple pathophysiological mechanisms. Asymmetric dimethylarginine (ADMA) is the major inhibitor of nitric oxide (NO). In this study, we aimed to investigate the relationship between plasma ADMA levels and syncope during the head-up tilt (HUT) test. : Overall, 97 patients were included in this study. They were above 18 years of age and were admitted to our clinic with the complaint of at least one episode of syncope consistent with VVS. The HUT test was performed in all patients. Patients were divided into the following two groups based on the HUT test results: group 1 included 57 patients with a positive HUT test and group 2 included 35 patients with a negative HUT test. Blood samples were taken before and immediately after the HUT test to measure ADMA levels. : No significant intergroup differences were observed concerning gender and age (female gender 68% vs 60%; mean age 24.85 ± 4.01 vs 25.62 ± 3.54 years, respectively, for groups 1 and 2). ADMA values were similar between groups 1 and 2 before the HUT test [ADMA of 958 (544-1418) vs 951 (519-1269); 0.794]. In the negative HUT group, no significant differences were observed in ADMA levels before and after the HUT test [ADMA of 951 (519-1269) vs 951 (519-1566); 0.764]. However, in the positive HUT group, ADMA levels were significantly decreased following the HUT test [pretest ADMA of 958 (544-1418) vs post-test ADMA of 115 (67-198); < 0.001]. : ADMA levels significantly decreased after the HUT test in patients with VVS.
血管迷走性晕厥（VVS）是晕厥最常见的病因，具有多种病理生理机制。不对称二甲基精氨酸（ADMA）是一氧化氮（NO）的主要抑制剂。在本研究中，我们旨在探讨头高位倾斜（HUT）试验期间血浆ADMA水平与晕厥之间的关系。
总体而言，本研究纳入了97例患者。他们年龄在18岁以上，因至少有一次符合VVS的晕厥发作而入住我们的诊所。所有患者均进行了HUT试验。根据HUT试验结果将患者分为以下两组：第1组包括57例HUT试验阳性的患者，第2组包括35例HUT试验阴性的患者。在HUT试验前和试验后立即采集血样以测量ADMA水平。
在性别和年龄方面未观察到显著的组间差异（第1组和第2组的女性分别为68%和60%；平均年龄分别为24.85±4.01岁和25.62±3.54岁）。在HUT试验前，第1组和第2组的ADMA值相似[ADMA分别为958（544 - 1418）和951（519 - 1269）；P = 0.794]。在HUT试验阴性组中，HUT试验前后的ADMA水平无显著差异[ADMA分别为951（519 - 1269）和951（519 - 1566）；P = 0.764]。然而，在HUT试验阳性组中，HUT试验后ADMA水平显著降低[试验前ADMA为958（544 - 1418），试验后ADMA为115（67 - 198）；P < 0.001]。
VVS患者在HUT试验后ADMA水平显著降低。
