Az L-arginin-útvonal metabolitjai differenciálhatják a paroxysmalis pitvarfibrillációt a permanenstől akut ischaemiás stroke-ban

L-arginine pathway metabolites can discriminate paroxysmal from permanent atrial fibrillation in acute ischemic stroke

Péter Csecsei, Réka Várnai, Lajos Nagy, Sándor Kéki, Tihamér Molnár, Zsolt Illés, Nelli Farkas, László Szapáry

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background and purpose: Atrial fibrillation (AF) is the most common arrhythmia diagnosed in clinical practice. We aimed to measure the L-arginine pathway metabolites as well as their ratios in patients with different types of AF or sinus rhythm and to explore the relationship among the markers and clinical variables in the subacute phase of acute ischemic stroke (AIS). Methods: A total of 46 patients with AIS were prospectively enrolled. The patients were divided into three groups based on diagnosis of either sinus rhythm, paroxysmal or permanent AF. Plasma concentration of the L-arginine pathway metabolites were analyzed at post-stroke 24 hours in the three rhythm groups. Besides, clinical variables and laboratory data were recorded. Results: Asymmetric dimetylarginine (ADMA) was significantly higher in patients with permanent AF compared to sinus rhythm (p<0.001). Both ADMA (p<0.001) and symmetric dimethylarginine (SDMA) (p<0.002) at 24 hours were significantly higher among patients with permanent AF compared to those with paroxysmal AF. The L-arginine/SDMA (p<0.031) ratios at 24 hours were significantly higher among patients with sinus rhythm compared to those with permanent AF. ROC analysis also revealed that plasma SDMA cut-off level over 0.639 μmol/L discriminated permanent AF from paroxysmal AF or sinus rhythm with a 90.9% sensitivity and 77.1% specificity. Neutrophil-lymphocyte ratio also showed significantly higher value in individuals with both paroxysmal and permanent AF (p=0.029). Conclusion: Plasma level of SDMA could discriminate permanent from paroxysmal AF in the subacute phase of ischemic stroke. In addition, an increased neutrophil-lymphocyte ratio may suggest inflammatory process in the evolution of atrial fibrillation.

Original languageUndefined/Unknown
JournalIdeggyogyaszati Szemle
Volume72
Issue number3-4
Pages (from-to)79-88
ISSN0019-1442
DOIs
Publication statusPublished - 30. Mar 2019

Keywords

  • atrial fibrillation
  • ischemic stroke
  • L-arginine
  • Arginine/blood
  • Brain Ischemia
  • Humans
  • Biomarkers/blood
  • Stroke/blood
  • Atrial Fibrillation

Cite this

@article{e30e3cb2c1fe4d9d8ede751f000ec39f,
title = "Az L-arginin-{\'u}tvonal metabolitjai differenci{\'a}lhatj{\'a}k a paroxysmalis pitvarfibrill{\'a}ci{\'o}t a permanenstől akut ischaemi{\'a}s stroke-ban: L-arginine pathway metabolites can discriminate paroxysmal from permanent atrial fibrillation in acute ischemic stroke",
abstract = "Background and purpose: Atrial fibrillation (AF) is the most common arrhythmia diagnosed in clinical practice. We aimed to measure the L-arginine pathway metabolites as well as their ratios in patients with different types of AF or sinus rhythm and to explore the relationship among the markers and clinical variables in the subacute phase of acute ischemic stroke (AIS). Methods: A total of 46 patients with AIS were prospectively enrolled. The patients were divided into three groups based on diagnosis of either sinus rhythm, paroxysmal or permanent AF. Plasma concentration of the L-arginine pathway metabolites were analyzed at post-stroke 24 hours in the three rhythm groups. Besides, clinical variables and laboratory data were recorded. Results: Asymmetric dimetylarginine (ADMA) was significantly higher in patients with permanent AF compared to sinus rhythm (p<0.001). Both ADMA (p<0.001) and symmetric dimethylarginine (SDMA) (p<0.002) at 24 hours were significantly higher among patients with permanent AF compared to those with paroxysmal AF. The L-arginine/SDMA (p<0.031) ratios at 24 hours were significantly higher among patients with sinus rhythm compared to those with permanent AF. ROC analysis also revealed that plasma SDMA cut-off level over 0.639 μmol/L discriminated permanent AF from paroxysmal AF or sinus rhythm with a 90.9{\%} sensitivity and 77.1{\%} specificity. Neutrophil-lymphocyte ratio also showed significantly higher value in individuals with both paroxysmal and permanent AF (p=0.029). Conclusion: Plasma level of SDMA could discriminate permanent from paroxysmal AF in the subacute phase of ischemic stroke. In addition, an increased neutrophil-lymphocyte ratio may suggest inflammatory process in the evolution of atrial fibrillation.",
keywords = "atrial fibrillation, ischemic stroke, L-arginine, Arginine/blood, Brain Ischemia, Humans, Biomarkers/blood, Stroke/blood, Atrial Fibrillation",
author = "P{\'e}ter Csecsei and R{\'e}ka V{\'a}rnai and Lajos Nagy and S{\'a}ndor K{\'e}ki and Tiham{\'e}r Moln{\'a}r and Zsolt Ill{\'e}s and Nelli Farkas and L{\'a}szl{\'o} Szap{\'a}ry",
year = "2019",
month = "3",
day = "30",
doi = "10.18071/isz.72.0079",
language = "Udefineret/Ukendt",
volume = "72",
pages = "79--88",
journal = "Ideggyogyaszati Szemle",
issn = "0019-1442",
publisher = "Literatura Medica Kiado",
number = "3-4",

}

Az L-arginin-útvonal metabolitjai differenciálhatják a paroxysmalis pitvarfibrillációt a permanenstől akut ischaemiás stroke-ban : L-arginine pathway metabolites can discriminate paroxysmal from permanent atrial fibrillation in acute ischemic stroke. / Csecsei, Péter; Várnai, Réka; Nagy, Lajos; Kéki, Sándor; Molnár, Tihamér; Illés, Zsolt; Farkas, Nelli; Szapáry, László.

In: Ideggyogyaszati Szemle, Vol. 72, No. 3-4, 30.03.2019, p. 79-88.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Az L-arginin-útvonal metabolitjai differenciálhatják a paroxysmalis pitvarfibrillációt a permanenstől akut ischaemiás stroke-ban

T2 - L-arginine pathway metabolites can discriminate paroxysmal from permanent atrial fibrillation in acute ischemic stroke

AU - Csecsei, Péter

AU - Várnai, Réka

AU - Nagy, Lajos

AU - Kéki, Sándor

AU - Molnár, Tihamér

AU - Illés, Zsolt

AU - Farkas, Nelli

AU - Szapáry, László

PY - 2019/3/30

Y1 - 2019/3/30

N2 - Background and purpose: Atrial fibrillation (AF) is the most common arrhythmia diagnosed in clinical practice. We aimed to measure the L-arginine pathway metabolites as well as their ratios in patients with different types of AF or sinus rhythm and to explore the relationship among the markers and clinical variables in the subacute phase of acute ischemic stroke (AIS). Methods: A total of 46 patients with AIS were prospectively enrolled. The patients were divided into three groups based on diagnosis of either sinus rhythm, paroxysmal or permanent AF. Plasma concentration of the L-arginine pathway metabolites were analyzed at post-stroke 24 hours in the three rhythm groups. Besides, clinical variables and laboratory data were recorded. Results: Asymmetric dimetylarginine (ADMA) was significantly higher in patients with permanent AF compared to sinus rhythm (p<0.001). Both ADMA (p<0.001) and symmetric dimethylarginine (SDMA) (p<0.002) at 24 hours were significantly higher among patients with permanent AF compared to those with paroxysmal AF. The L-arginine/SDMA (p<0.031) ratios at 24 hours were significantly higher among patients with sinus rhythm compared to those with permanent AF. ROC analysis also revealed that plasma SDMA cut-off level over 0.639 μmol/L discriminated permanent AF from paroxysmal AF or sinus rhythm with a 90.9% sensitivity and 77.1% specificity. Neutrophil-lymphocyte ratio also showed significantly higher value in individuals with both paroxysmal and permanent AF (p=0.029). Conclusion: Plasma level of SDMA could discriminate permanent from paroxysmal AF in the subacute phase of ischemic stroke. In addition, an increased neutrophil-lymphocyte ratio may suggest inflammatory process in the evolution of atrial fibrillation.

AB - Background and purpose: Atrial fibrillation (AF) is the most common arrhythmia diagnosed in clinical practice. We aimed to measure the L-arginine pathway metabolites as well as their ratios in patients with different types of AF or sinus rhythm and to explore the relationship among the markers and clinical variables in the subacute phase of acute ischemic stroke (AIS). Methods: A total of 46 patients with AIS were prospectively enrolled. The patients were divided into three groups based on diagnosis of either sinus rhythm, paroxysmal or permanent AF. Plasma concentration of the L-arginine pathway metabolites were analyzed at post-stroke 24 hours in the three rhythm groups. Besides, clinical variables and laboratory data were recorded. Results: Asymmetric dimetylarginine (ADMA) was significantly higher in patients with permanent AF compared to sinus rhythm (p<0.001). Both ADMA (p<0.001) and symmetric dimethylarginine (SDMA) (p<0.002) at 24 hours were significantly higher among patients with permanent AF compared to those with paroxysmal AF. The L-arginine/SDMA (p<0.031) ratios at 24 hours were significantly higher among patients with sinus rhythm compared to those with permanent AF. ROC analysis also revealed that plasma SDMA cut-off level over 0.639 μmol/L discriminated permanent AF from paroxysmal AF or sinus rhythm with a 90.9% sensitivity and 77.1% specificity. Neutrophil-lymphocyte ratio also showed significantly higher value in individuals with both paroxysmal and permanent AF (p=0.029). Conclusion: Plasma level of SDMA could discriminate permanent from paroxysmal AF in the subacute phase of ischemic stroke. In addition, an increased neutrophil-lymphocyte ratio may suggest inflammatory process in the evolution of atrial fibrillation.

KW - atrial fibrillation

KW - ischemic stroke

KW - L-arginine

KW - Arginine/blood

KW - Brain Ischemia

KW - Humans

KW - Biomarkers/blood

KW - Stroke/blood

KW - Atrial Fibrillation

U2 - 10.18071/isz.72.0079

DO - 10.18071/isz.72.0079

M3 - Tidsskriftartikel

VL - 72

SP - 79

EP - 88

JO - Ideggyogyaszati Szemle

JF - Ideggyogyaszati Szemle

SN - 0019-1442

IS - 3-4

ER -