ADMA in chronic heart failure

Many patients with chronic heart failure show higher ADMA levels compared with healthy people [41,50]. In these patients ADMA correlates with the severity of endothelial dysfunction and allows a forecast about the possibility to restore endothelial function via supplementation with L-arginine [50].

In a study involving 198 patients with end-stage renal failure, left ventricular function was measured via echocardiography and correlated with ADMA concentration. A significant relationship between ADMA levels and left ventricular mass and an inverse correlation between ADMA and left ventricular ejection fraction was found [51], indicating a possible involvement of ADMA in hyper-tension-related myocardial remodeling.

Another finding that appears to be of relevance for the pathophysiological implications associated with elevated ADMA levels was the existence of an inverse relationship between ADMA and maximal oxygen consumption during physical exercise [50].

Figure 16. In patients with congestive heart failure ADMA concentration is elevated as compared to healthy controls; ADMA levels correlate with the degree of improvement in endothelium-dependent vascular function by L-arginine.