Plasma levels of NO-related pathway molecules to predict post-transcatheter aortic valve implantation major adverse cardiovascular events: a prospective, multicenter study.

INTRODUCTION

Aortic stenosis (AS) is associated with alterations in the concentrations of nitric oxide (NO)-related pathway molecules, including arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA).

AIM

We aimed to determine the effect of transcatheter aortic valve implantation (TAVI) on the concentrations of arginine, ADMA, and SDMA and to evaluate their predictive value for post-TAVI outcomes.

MATERIAL AND METHODS

In total, 128 patients with AS referred for TAVI were enrolled in the study. Blood samples were collected 1 day before TAVI and at hospital discharge. Concentrations of arginine, ADMA, and SDMA were measured using ultra performance liquid chromatography coupled with mass spectrometry.

RESULTS

Plasma concentrations of arginine, ADMA, and SDMA did not change after TAVI, compared to baseline ( ≥ 0.70 for all). The median time of follow-up was 13.5 months. Arginine, ADMA, and SDMA did not predict post-TAVI MACE during the follow-up time ( ≥ 0.88). There were significant negative correlations between the concentrations of ADMA and SDMA and echocardiographic parameters of AS severity before TAVI ( < 0.01 for all).

CONCLUSIONS

Plasma concentrations of arginine, ADMA, and SDMA were not affected by TAVI and did not predict post-TAVI MACE. ADMA and SDMA negatively correlated with AS severity, which might indicate alterations in the NO/L-arginine pathway in patients with AS.