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Role of plasma asymmetric dimethyl-L-arginine levels in detection of pulmonary hypertension in children with CHD

Published online by Cambridge University Press:  28 June 2018

Marwa Farag ,
Doaa El Amrousy ,
Hesham El-Serogy  and
Amr Zoair
Marwa Farag
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Doaa El Amrousy*
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Hesham El-Serogy
Affiliation:
Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Amr Zoair
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
*
Author for correspondence: Professor D. El Amrousy, Assistant Professor of Pediatrics, Tanta University Hospital, El motasem street No. 6, Tanta, Egypt. Tel: +201 278 155 283; Fax: +204 032 80477; E-mail: doaamoha@yahoo.com
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Abstract

Objectives

The objectives of this study were to evaluate the plasma levels of asymmetric dimethyl-L-arginine in children with pulmonary hypertension due to CHD before and after treatment with sildenafil and to evaluate its diagnostic and prognostic value as a biomarker in such children.

Methods

A total of 60 children with CHD and 30 healthy control children matched for age and sex were recruited. Children with CHD were divided into two equal groups: the normal pulmonary pressure group (n=30) and the pulmonary hypertension group (n=30). Children with pulmonary hypertension were treated with sildenafil and were followed up for 6 months. Clinical data, haemodynamic parameters, echocardiographic examination, and asymmetric dimethyl-L-arginine levels were evaluated before and after treatment.

Results

Asymmetric dimethyl-L-arginine levels were significantly higher in patients with pulmonary hypertension than in those with CHD-only or the control group, and this increase was positively correlated with increased severity of pulmonary hypertension. Asymmetric dimethyl-L-arginine levels, mean pulmonary artery pressure, and pulmonary vascular resistance were significantly decreased after treatment with sildenafil. Moreover, asymmetric dimethyl-L-arginine level was significantly lower in patients who responded to sildenafil treatment compared with those who did not. At a cut-off point of more than 0.85 nmol/ml, asymmetric dimethyl-L-arginine has a sensitivity of 83% and a specificity of 80% to diagnose pulmonary hypertension-CHD. Asymmetric dimethyl-L-arginine has a sensitivity of 100% and a specificity of 94% to predict poor prognosis in pulmonary hypertension-CHD children at a cut-off point of 1.3 nmol/ml.

Conclusion

Asymmetric dimethyl-L-arginine level has a good diagnostic and prognostic value as a biomarker in children with pulmonary hypertension-CHD and can be used for following up patients with pulmonary hypertension and predicting response to treatment.

Keywords

Asymmetric dimethyl-L-argininepulmonary hypertension-CHDprognosisdiagnosis
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 9 , September 2018 , pp. 1163 - 1168
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Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Farag M, El Amrousy D, El-SerogyH, Zoair A. (2018) Role of plasma asymmetric dimethyl-L-arginine levels in detection of pulmonary hypertension in children with CHD. Cardiology in the Young28: 1163–1168. doi: 10.1017//S1047951118001026

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