Abstract
Low homoarginine is an independent marker of mortality in heart failure patients and incident cardiovascular events. Whether homoarginine is related with healthier cardiac structure and function is currently unclear. We used data of the population-based “Study of Health in Pomerania” (SHIP-Trend) to assess this relation. Homoarginine was measured in serum using liquid chromatography-tandem mass spectrometry. Linear regression models assessed the relation between homoarginine and several structural as well as functional parameters and N-terminal pro B-type natriuretic peptide (NTproBNP). All models were adjusted for age, sex, body mass index, and renal function. A total of 3113 subjects (median age 48 (25th percentile 37 to 75th percentile 60) years, 46% male) were included. A standard deviation decrease in homoarginine was associated with a larger left ventricular diastolic diameter (0.3; 95%-confidence interval (CI): 0.2 to 0.5 mm; p < 0.001), left ventricular systolic diameter (0.38; 95%-CI: −0.22 to 0.54 mm; p < 0.001) as well as a less relative wall thickness (–0.003 95%-CI: −0.006 to −0.0008; p = 0.01), left ventricular ejection fraction (–0.47; 95%-CI: –0.79 to −0.15%; p < 0.01) and fractional shortening (−0.35; 95%-CI: −0.62 to 0.07%; p = 0.01). Low homoarginine was also related to higher NTproBNP (−0.02 95%-CI: −0.034 to −0.009 log pg/mL; p < 0.01). Lower serum homoarginine is associated with dilatation of the heart and decreased function. Prospective clinical studies should assess if homoarginine supplementation improves cardiac health in subjects with low serum concentrations.
Highlights
L -arginine (Arg) is a semi-essential amino acid with a vital role in living organisms, being part of several metabolic pathways [1]
Even though hArg may serve as an alternative substrate for nitric oxide (NO) and inhibits arginase in a similar extend compared to lysine, its low physiological concentration and affinity to enzymes make hArg unlikely to play a significant role in the physiology of the NO pathway [3,4]
We found no association between right ventricular structural (RV and Right ventricular outflow tract (RVOT)), systolic functional (TAPSE, Pulmonary valve (PV) acc. time, and PV acc. slope), and diastolic functional
Summary
L -arginine (Arg) is a semi-essential amino acid with a vital role in living organisms, being part of several metabolic pathways [1]. Even though hArg may serve as an alternative substrate for NO and inhibits arginase in a similar extend compared to lysine, its low physiological concentration and affinity to enzymes make hArg unlikely to play a significant role in the physiology of the NO pathway [3,4]. Recent experimental and clinical data indicate a potential role of hArg in cardiovascular disease (CVD), since hArg deficiency or impairment is associated with adverse outcomes [5,6,7,8]. Low serum hArg concentrations were related to an increased risk for all-cause and CVD mortality. Low hArg was an independent marker of all-cause mortality in this cohort [12]
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