Asymmetrical dimethylarginine--more sensitive than NT-proBNP to diagnose heart failure in adults with congenital heart disease |
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Authors: | Tutarel Oktay Denecke Agnieszka Bode-Böger Stefanie M Martens-Lobenhoffer Jens Lovric Svjetlana Bauersachs Johann Schieffer Bernhard Westhoff-Bleck Mechthild Kielstein Jan T |
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Affiliation: | Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany. otutarel@hotmail.com |
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Abstract: | BackgroundChronic 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.MethodsIn 102 patients ADMA and NT-proBNP were measured and related to NYHA class, systemic ventricular function and parameters of cardiopulmonary exercise testing.ResultsIn 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.ConclusionADMA 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. |
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