Clinical significance of homoarginine level in patients with ascending aortic aneurysm and aortic stenosis

Objective. To assess homoarginine (hArg) level in patients with ascending aortic aneurysm and aortic stenosis. Design and methods. The study included 26 patients with ascending aortic aneurysm and 19 patients with aortic stenosis. The comparison group consisted of 30 healthy donors. Plasma levels of hArg, asymmetric dimethylarginine (ADMA), and the parameters of mitochondrial dysfunction (pyruvic acid, PGC-1a protein, lactic acid, cytochrome C) were determined. Results. Patients with ascending aortic aneurysm and aortic stenosis demonstrated a decrease in the level of serum hArg (p = 0,002), most pronounced in the group with ascending aortic aneurysm, an increase in ADMA and markers of mitochondrial dysfunction-lactic acid, PGC-1a protein. There was no relation between hArg level and well-known metabolic markers of mitochondrial (lactic and pyruvic acids) and endothelial dysfunction (ADMA). The following factors contributed to the lowering of hArg levels: an increased body mass index (rs = –0,34, p = 0,02), impaired glucose tolerance (p = 0,006), and myocardial infarction (p = 0,09). In a subgroup of patients with a tricuspid aortic valve and ascending aortic aneurysm, an inverse relationship was found between hArg level and descending thoracic aortic diameter (rs = –0,5, p < 0,05). Conclusion. The decreased level of hArg is a marker of mitochondrial and endothelial dysfunction in patients with ascending aortic aneurysm and aortic stenosis, especially in patients with myocardial infarction, obesity and diabetes mellitus.

aortic aneurysm, aortic stenosis, homoarginine

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