OBJECTIVE: This study examined the effect of endoscopic sinus surgery (ESS) on plasma levels of asymmetric dimethylarginine (ADMA) and mean pulmonary arterial pressure (mPAP) in patients with extensive nasal polyposis (ENP). METHODS: Preoperative and 3-month post-ESS plasma levels of ADMA and mPAP were measured in patients with ENP and in age-and gender-matched controls. RESULTS: The study included 45 patients with ENP and 31 controls (mean ± SD age 39.4 ± 8.8 and 38.1 ± 9.6 years, respectively). The mean preoperative ADMA level in ENP patients (0.69 ± 0.27 μmol/l) was statistically significantly lower than in the control group (1.08 ± 0.37 μmol/l). The postoperative ADMA level increased significantly in ENP patients (0.97 ± 0.36 μmol/l) versus the preoperative level. Mean preoperative mPAP in ENP patients (25.7 ± 5.4 mmHg) was statistically significantly higher than in the control group (20.8 ± 2.1 mmHg), and ENP patients showed significant decreases in mPAP after (21.9 ± 3.5 mmHg) versus before ESS. CONCLUSION: Patients with ENP had lower plasma ADMA levels compared with healthy controls, however ADMA levels and mPAP improved in ENP patients after ESS.
FidanVAksakalE: Effects of endoscopic sinus surgery on pulmonary artery pressure in patients with extensive nasal polyposis. J Craniofac Surg2011; 22: 592–593.
3.
LukeMJMehriziAFolgerGMJr: Chronic nasopharyngeal obstruction as a cause of cardiomegaly, cor pulmonale, and pulmonary edema. Pediatrics1966; 37: 762–768.
4.
MenaschVDFarrehiCMillerM: Hypoventilation and cor pulmonale due to chronic upper airway obstruction. J Pediatr1965; 67: 198–203.
5.
BayrakPKirmazCSekuriC: Is pulmonary arterial pressure affected by allergic rhinitis with nasal obstruction?Asian Pac J Allergy Immunol2007; 25: 121–126.
6.
PastoMSerranoEUrocosteE: Nasal polyp-derived superoxide anion: dose-dependent inhibition by nitric oxide and pathophysiological implications. Am J Respir Crit Care Med2001; 163: 145–151.
7.
SibalLAgarwalSCHomePD: The role of asymmetric dimethylarginine (ADMA) in endothelial dysfunction and cardiovascular disease. Curr Cardiol Rev2010; 6: 82–90.
8.
LeiperJMVallanceP: The synthesis and metabolism of asymmetric dimethylarginine (ADMA). Eur J Clin Pharmacol2006; 62: 33–38.
9.
RochaMApostolovaNMijaresA Hernandez: Oxidative stress and endothelial dysfunction in cardiovascular disease: mitochondria-targeted therapeutics. Curr Med Chem2010; 17: 3827–3841.
10.
Ruiz-HurtadoGDelgadoC: Nitric oxide pathway in hypertrophied heart: new therapeutic uses of nitric oxide donors. J Hypertens2010; 28 (suppl 1): S56–S61.
11.
DemarcoVGWhaley-ConnellATSowersJR: Contribution of oxidative stress to pulmonary arterial hypertension. World J Cardiol2010; 2: 316–324.
12.
SimJY: Nitric oxide and pulmonary hypertension. Korean J Anesthesiol2010; 58: 4–14.
13.
SchulzeFLenzenHHanefeldC: Asymmetric dimethylarginine is an independent risk factor for coronary heart disease: results from the multicenter Coronary Artery Risk Determination investigating the Influence of ADMA Concentration (CARDIAC) study. Am Heart J2006; 152: 493.e1–498.e8.
14.
CaySCagirciGAkcayM: Asymmetric dimethylarginine levels in patients with coronary artery ectasia. Kardiol Pol2009; 67: 1362–1368.
15.
BestermannWHJr: The ADMA-metformin hypothesis: linking the cardiovascular consequences of the metabolic syndrome and type 2 diabetes. Cardiorenal Med2011; 1: 211–219.
16.
FokkensWLundVMullolJon behalf of the European Position Paper on Rhinosinusitis and Nasal Polyps Group: European position paper on rhinosinusitis and nasal polyps. Rhinology2007; 45 (suppl 20): 1–136.
17.
StammbergerH: Endoscopic endonasal surgery—concepts in treatment of recurring rhinosinusitis. Part II. Surgical technique. Otolaryngol Head Neck Surg1986; 94: 147–156.
18.
MoncadaSHiggsA: The L-arginine-nitric oxide pathway. N Engl J Med1993; 329: 2002–2012.
19.
TakemotoMEgashiraKUsuiM: Important role of tissue angiotensin converting enzyme activity in the pathogenesis of coronary vascular and myocardial structural changes induced by long-term blockade of nitric oxide synthesis in rats. J Clin Invest1997; 99: 278–287.
20.
WangHLiuJ: Plasma asymmetric dimethylarginine and L-arginine levels in Chinese patients with essential hypertension without coronary artery disease. J Cardiovasc Dis Res2011; 2: 177–180.
21.
LückeTKanzelmeyerNKemperMJ: Developmental changes in the L-arginine/nitric oxide pathway from infancy to adulthood: plasma asymmetric dimethylarginine levels decrease with age. Clin Chem Lab Med2007; 45: 1525–1530.
22.
HasanoğluAOkurIOrenAC: The levels of asymmetric dimethylarginine, homocysteine and carotid intima-media thickness in hypercholesterolemic children. Turk J Pediatr2011; 53: 522–527.
23.
BeltowskiJKedraA: Asymmetric dimethylarginine (ADMA) as a target for pharmacotherapy. Pharmacol Rep2006; 58: 159–178.
24.
BögerRHBode-BögerSMSzubaA: Asymmetric dimethylarginine (ADMA): A novel risk factor for endothelial dysfunction: its role in hypercholesterolemia. Circulation1998; 98: 1842–1847.
25.
MasudaHGotoMTamaokiS: Accelerated intimal hyperplasia and increased endogenous inhibitors for NO synthesis in rabbits with alloxan-induced hyperglycaemia. Br J Pharmacol1999; 126: 211–218.
26.
LuTMChungMYLinMW: Plasma asymmetric dimethylarginine predicts death and major adverse cardiovascular events in individuals referred for coronary angiography. Int J Cardiol2011; 153: 135–140.
27.
AungTBisognanoJDMorganMA: Allergic respiratory disease as a potential comorbidity for hypertension. Cardiol J2010; 17: 443–447.
28.
KimJPurushottamBChaeYK: Relation between common allergic symptoms and coronary heart disease among NHANES III participants. Am J Cardiol2010; 106: 984–987.
29.
VereshZRaczALotzG: ADMA impairs nitric oxide-mediated arteriolar function due to increased superoxide production by angiotensin II-NAD(P)H oxidase pathway. Hypertension2008; 52: 960–966.
30.
GorenfloMZhengCWerleE: Plasma levels of asymmetrical dimethyl-L-arginine in patients with congenital heart disease and pulmonary hypertension. J Cardiovasc Pharmacol2001; 37: 489–492.
