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Open AccessArticle

Serum Asymmetric Dimethylarginine Levels in Patients with Vasovagal Syncope

Cardiology Department, Istanbul Medeniyet University, Goztepe Training and Research Hospital, 34722 Istanbul, Turkey
Cardiology Department, Okmeydani Training and Research Hospital, 34384 Istanbul, Turkey
Cardiology Department, Istanbul University Istanbul School of Medicine, 34093 Istanbul, Turkey
Biochemistry Department, Hitit University, Erol Olcok Training and Research Hospital, 19040 Corum, Turkey
Cardiology Department, Adiyaman Training and Research Hospital, 02200 Adiyaman, Turkey
Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, 34668 Istanbul, Turkey
Cardiology Department, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, 34096 Istanbul, Turkey
Cardiology Department, Bagcilar Training ve Research Hospital, Bagcilar Center, 34100 Istanbul, Turkey
Author to whom correspondence should be addressed.
Medicina 2019, 55(11), 718;
Received: 27 September 2019 / Revised: 9 October 2019 / Accepted: 10 October 2019 / Published: 29 October 2019
Background and Objectives: Vasovagal syncope (VVS) is the most common cause of syncope and has multiple pathophysiological mechanisms. Asymmetric dimethylarginine (ADMA) is the major inhibitor of nitric oxide (NO). In this study, we aimed to investigate the relationship between plasma ADMA levels and syncope during the head-up tilt (HUT) test. Materials and Methods: Overall, 97 patients were included in this study. They were above 18 years of age and were admitted to our clinic with the complaint of at least one episode of syncope consistent with VVS. The HUT test was performed in all patients. Patients were divided into the following two groups based on the HUT test results: group 1 included 57 patients with a positive HUT test and group 2 included 35 patients with a negative HUT test. Blood samples were taken before and immediately after the HUT test to measure ADMA levels. Results: No significant intergroup differences were observed concerning gender and age (female gender 68% vs 60%; mean age 24.85 ± 4.01 vs 25.62 ± 3.54 years, respectively, for groups 1 and 2). ADMA values were similar between groups 1 and 2 before the HUT test [ADMA of 958 (544–1418) vs 951 (519–1269); p = 0.794]. In the negative HUT group, no significant differences were observed in ADMA levels before and after the HUT test [ADMA of 951 (519–1269) vs 951 (519–1566); p = 0.764]. However, in the positive HUT group, ADMA levels were significantly decreased following the HUT test [pretest ADMA of 958 (544–1418) vs post-test ADMA of 115 (67–198); p < 0.001]. Conclusion: ADMA levels significantly decreased after the HUT test in patients with VVS.
Keywords: Vasovagal syncope; head-up tilt test; asymmetric dimethylarginine; nitric oxide Vasovagal syncope; head-up tilt test; asymmetric dimethylarginine; nitric oxide
MDPI and ACS Style

Atıcı, A.; Aciksari, G.; Baycan, O.F.; Barman, H.A.; Sonsöz, M.R.; Sahin, M.; Asoglu, R.; Demirkıran, A.; Kul, Ş.; Gungor, B.; Durmaz, E.; Bilge, A.K.; Sahin, I. Serum Asymmetric Dimethylarginine Levels in Patients with Vasovagal Syncope. Medicina 2019, 55, 718.

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