PLoS ONE (Jan 2012)

Asymmetrical dimethylarginine--more sensitive than NT-proBNP to diagnose heart failure in adults with congenital heart disease.

  • Oktay Tutarel,
  • Agnieszka Denecke,
  • Stefanie M Bode-Böger,
  • Jens Martens-Lobenhoffer,
  • Svjetlana Lovric,
  • Johann Bauersachs,
  • Bernhard Schieffer,
  • Mechthild Westhoff-Bleck,
  • Jan T Kielstein

DOI
https://doi.org/10.1371/journal.pone.0033795
Journal volume & issue
Vol. 7, no. 3
p. e33795

Abstract

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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. METHODS: In 102 patients ADMA and NT-proBNP were measured and related to NYHA class, systemic ventricular function and parameters of cardiopulmonary exercise testing. 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. 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.