Abstract
Abstract Background Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthases (NOS) that limits nitric oxide (NO) bioavailability and can increase production of NOS derived reactive oxidative species. ADMA has been found as a novel risk marker in cardiovascular diseases.In Beta-Thalassemia, little is known about the importance of the baseline ADMA determination as a risk marker of cardiovascular complications in β thalassemic patients Objectives to assess the levels of ADMA in children and adolescents with β thalassemia major and intermedia and determine their correlation with cardiovascular complications. Patients and Methods The level of ADMA was measured in 60 children and adolescent with β thalassemia syndrome without known heart disease compared with 20 healthy controls using enzyme-linked immunosorbent assay (ELISA). Results ADMA levels were significantly higher in patients with β-thalassemia than control group (P< 0.001). Body weight, male gender, regular blood transfusion and blood transfusion index had significant impact on serum ADMA. A significant correlation was found between ADMA and both bilirubin and lactate dehydrogenas (LDH) levels.Moreover, a significant positive correlation was reported between ADMA level and both left ventricular end diastolic diameter (LVEDD) and right ventricular systolic pressure (RVSP) in addition to a significant negative correlation between ADMA and ejection fraction (EF) as well as fractional shortening (FS). Additionaly, association of serum ADMA concentration to left ventricular dysfunction and pulmonary hypertension in β thalassemia patients was found. Conclusion ADMA could be considered as an early marker of cardiovascular complications in thalassemic patients. It should be incorporated in follow-up of thalassemics so identifying and treating appropriately subclinical conditions, reducing the burden of deleterious heart failure.
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