Effects of coronary revascularization with or without cardiopulmonary bypass on plasma levels of asymmetric dimethylarginine

Attila Cziráki, Zénó Ajtay, Ádám Németh, Zsófia Lenkey, Endre Sulyok, Sándor Szabados, Nasri Alotti, Jens Martens-Lobenhoffer, Csaba Szabó, Stefanie M. Bode-Böger

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objectives: We measured and compared serum asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-arginine levels in patients undergoing coronary artery revascularization. Methods: Two groups of patients with coronary artery disease were subjected to coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB; n=20) or with off-pump CABG surgery (OPCABG; n=21). Blood samples for measurements of ADMA, SDMA, and L-arginine were withdrawn and determined by liquid chromatography-tandem mass spectrometry from the coronary sinus (CS) and from the peripheral vein. Results: On the basis of the intraoperative (CS) samples, ADMA levels rose in the CPB group (F=0.416, P<0.685 and F=14.751, P<0.001 for OPCABG and CPB groups, respectively). A similar significant increase of ADMA was observed in the peripheral blood (F=30.738, P<0.001) during CPB, whereas ADMA levels remained unchanged during OPCABG. The time course of L-arginine levels was significantly different in the blood samples from CS (F=3.255, P<0.05), when compared with samples from the peripheral blood (F=3.255, P<0.05). The values of the L-arginine/ADMA ratio were significantly higher in the OPCABG group at baseline and on the first postoperative day compared with the results of the CPB group (178.29±11.56 vs. 136.28±13.72 and 129.43±7.08 vs. 106.8±6.9 for OPCABG and CPB groups, respectively). Conclusion: Plasma levels of ADMA, SDMA, L-arginine, and L-arginine/ADMA ratio are reliable and feasible markers of an early ischemia-reperfusion injury. During CPB operation, the plasma concentration of ADMA increased significantly and remained elevated until the first postoperative day due to extensive ischemia-reperfusion injury caused by CPB.

Original languageEnglish (US)
Pages (from-to)245-252
Number of pages8
JournalCoronary Artery Disease
Issue number4
StatePublished - Jun 2011
Externally publishedYes


  • Asymmetric dimethylarginine
  • coronary heart disease
  • revascularization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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