Asymmetrical Dimethylarginine - More Sensitive than NT-proBNP to Diagnose Heart Failure in Adults with Congenital Heart Disease

作者：Tutarel Oktay^*; Denecke Agnieszka; Bode Boeger Stefanie M; Martens Lobenhoffer Jens; Lovric Svjetlana; Bauersachs Johann; Schieffer Bernhard; Westhoff Bleck Mechthild; Kielstein Jan T

来源：PLos One, 2012, 7(3): e33795.

DOI：10.1371/journal.pone.0033795

Background: Chronic heart failure is an important cause for morbidity and mortality in adults with congenital heart disease (ACHD). While NT-proBNP is an established biomarker for heart failure of non-congenital origin, its value in ACHD has limitations. Asymmetrical dimethylarginine (ADMA) correlates with disease severity and independently predicts adverse clinical events in heart failure of non-congenital origin. Its role in ACHD has not been investigated. %26lt;br%26gt;Methods: In 102 patients ADMA and NT-proBNP were measured and related to NYHA class, systemic ventricular function and parameters of cardiopulmonary exercise testing. %26lt;br%26gt;Results: In contrast to NT-proBNP ADMA differentiated between NYHA classes I-III. Both, ADMA and NT-proBNP showed a good correlation with parameters of cardiopulmonary exercise testing with comparable receiver-operating characteristic curves for identifying patients with severely limited cardiopulmonary exercise capacity. %26lt;br%26gt;Conclusion: ADMA seems to be a better biomarker than NT-proBNP for the assessment of NYHA class and as a good as NT-proBNP for the estimation of maximum exercise capacity in adults with congenital heart disease. Its use in clinical routine should be evaluated.

• 出版日期2012-3-21