Abstract
Post-infarction heart failure with preserved ejection fraction (HFpEF) determines a great morbidity and mortality, and given the physiopathology implications of advanced glycation end products (AGEs) in the genesis of myocardial dysfunction. As known endothelial dysfunction is an independent predictor for cardiovascular disease. L-Arginine is the amino acid with potential to improve endothelial function which leading to prevention and treatment of cardiovascular diseases, and we think that L-Arginine may decrease the serum AGEs. We aimed to estimate the value of AGEs in post-infarction HFpEF patients, and detect the effect of L-Arginine on the serum level of AGEs in post-infarction HFpEF pts. all individuals (25) included aged 40 to 80 years, 20(80%) males and 5(20%) females were diagnosed with (HFpEF) according to ESC guidelines (2012), and their functional class according to NYHA classification for HF. 20(80%) patients of them have myocardial infarction in anamnesis. 1st group:13 patients with HFpEF and history of myocardial infarction with L-Arginine added to their standard treatment. 2nd group:7 patients with HFpEF and history of myocardial infarction with standard treatment (without L-Arginine). Comparsion group: 5 patients with HFpEF with standard treatment. We prescribed L. Arginine aspartate (Tivortin 4.2gm) intravenously once daily for 10 days for all 1st group patients. The levels of total cholesterol, triglycerides, glucose, white blood cells, erythrocyte sedimentation rate and AGEs serum level were deterimined. AGEs serum level increased markedly increased in middle-age pts with post infarction HFpEF. Inclusion of L-arginine aspartate in complex of treatment for post infarction HFpEF contributed to the significant decrease AGEs level in >60 years old patients.
Highlights
Chronic kidney disease (CKD) and cardiovascular disease (CVD) are strongly interlinked with each other, and they share common risk factors such as diabetes mellitus or hypertension [1]
All individuals (25) included aged 40 to 80 years, 20 males and 5 females were diagnosed with preserved ejection fraction chronic heart failure (HFpEF), according to ESC guidelines (2012) [31], and their functional class according to NYHA classification for HF. 20 patients of them have myocardial infarction in anamnesis
84% of heart failure with preserved ejection fraction (HFpEF) pts were with 3rd functional class (Fc) while 16% were with 2nd Fc, after 2 to 4 weeks of admission all 3rd Fc converted to 2.6 and 2.5 Fc, after 6 weeks all pts were with 2nd Fc
Summary
Chronic kidney disease (CKD) and cardiovascular disease (CVD) are strongly interlinked with each other, and they share common risk factors such as diabetes mellitus or hypertension [1]. In the context of CKD and CVD, the interest towards the post-translational modifications (PTMs) of proteins has grown considerably. PTMs are covalent changes of proteins or peptides that are altered either by proteolytic cleavage or by adding moieties to one or more amino acids. This enhances their complexity with respect to regulation of activity state, subcellular localization, turnover and interaction with other cellular molecules [2]. PTM proteins and peptides have gained attention as biomarkers and/or mediators of CVD and CKD [3, 4]
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