Abstract 420: The Ratio of L-arginine to Asymmetric Dimethylarginine is Associated With Brachial-ankle Pulse Wave Velocity in Patients Undergoing Coronary Angiography

Background Endothelial dysfunction decrease vasomotor function and cause vascular stiffening in addition to the structural changes. Relative L-arginine deficiency to ADMA influencing NO synthesis may increase arterial stiffness in elderly individuals. We investigated the relationship between the L-arginine / ADMA ratio and brachial ankle pulse wave velocity (baPWV) of the patients with suspected or already known coronary artery disease (CAD). Methods and Results The cross-sectional study enrolled 74 patients (67 ± 10 y/o) undergoing coronary angiography. There were 54 (73%) patients with CAD including 3 of coronary bypass surgery, and 11 of old myocardial infarction. Exclusion criteria were ankle brachial index (ABI) less than 0.9 in both lower extremities and hemodialysis. baPWV and ABI were obtained using an automatic waveform analyzer. Serum L-arginine, ADMA were measured by high-performance liquid chromatography. The ratio of L-arginine to ADMA was associated with baPWV (γ= -0.323, p=0.005) (Figure). Although the value of baPWV was dependent on systolic blood pressure and heart rate at measurement as reported previously, the ratio was a significant predictor of baPWV in multivariate analysis (β= -0.448, p<0.001). Additionally, serum L-arginine, and L-arginine / ADMA ratio were also independent contributing factors to baPWV in the subgroup of 46 elderly patients (>64 y/o). Conclusion We observed that many ageing patients with cardiovascular disease had low L-arginine / ADMA ratio accompanied with high baPWV. The findings suggested that correction of serum L-arginine level can be a therapeutic option to recover arterial compliance for the population.