ADMA, SDMA and L-arginine may be novel targets in pharmacotherapy for complications due to cardiopulmonary bypass

• Main Authors: Kahraman Aydin, Mutlu Emre, Aldag Mustafa
• Format: Article
• Language: English
• Published: Society of Medical Biochemists of Serbia, Belgrade 2017-01-01
• Series: Journal of Medical Biochemistry
• Subjects: asymmetric dimethylarginine (adma); symmetric dimethylarginine (sdma); l-arginine; cardiopulmonary bypass (cpb); renin-angiotensin system
• Online Access: https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2017/1452-82581701008K.pdf
• ISSN: 1452-8258; 1452-8266

Background: In this study, the effects of olmesartan therapy on asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), L-arginine and inducible nitric oxide synthase (iNOS) levels were investigated in patients undergoing cardiopulmonary bypass. Methods: Patients were randomly allocated to two groups, control and olmesartan. Olmesartan was administered 30 mg once a day beginning from preoperative day 5 to postoperative day 28 and on operation day. Blood was drawn from all patients and ADMA, SDMA, L-arginine and iNOS levels were analyzed at six time points (T1: before anesthesia induction, T2: during cardiopulmonary bypass, T3: five min after the cross-clamp was removed, T4: after protamine infusion, T5: on postoperative day 3 and T6: on postoperative day 28). Results: In the olmesartan treated group, iNOS levels exhibited significant decreases at T2, T3, T4, T5 and T6 time points compared with control group (p< 0.001, p< 0.05, p< 0.001, p< 0.01, p< 0.05 respectively). ADMA levels were significantly lower in olmesartan treated group than in control group at T3, T4, T5 and T6 time points (p< 0.05, p< 0.05, p< 0.05, p<0.01 respectively). SDMA levels at T2, T3 and T6 time points were higher in control group than olmesartan group. L-Arginine levels were significantly higher at T2 and T3 time points in olmesartan treated group than control group (p< 0.001, p< 0.01). Conclusions: It was concluded that administration of olmesartan reduced plasma ADMA, SDMA, iNOS levels and enhanced L-arginine level in CPB time and it could reduce potential postoperative complications through reducing oxidative stress and inflammatory response in the postoperative period after coronary bypass surgery.