Plasma levels of NO-related pathway molecules to predict post-transcatheter aortic valve implantation major adverse cardiovascular events: a prospective, multicenter study

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Introduction: Aortic stenosis (AS) is associated with alterations in the concentrations of nitric oxide (NO)-related pathway molecules, including arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA).Aim: We aimed to determine the effect of transcatheter aortic valve implantation (TAVI) on the concentrations of arginine, ADMA, and SDMA and to evaluate their predictive value for post-TAVI outcomes.Material and methods: In total, 128 patients with AS referred for TAVI were enrolled in the study.Blood samples were collected 1 day before TAVI and at hospital discharge.Concentrations of arginine, ADMA, and SDMA were measured using ultra performance liquid chromatography coupled with mass spectrometry.Results: Plasma concentrations of arginine, ADMA, and SDMA did not change after TAVI, compared to baseline (p ≥ 0.70 for all).The median time of follow-up was 13.5 months.Arginine, ADMA, and SDMA did not predict post-TAVI MACE during the follow-up time (p ≥ 0.88).There were significant negative correlations between the concentrations of ADMA and SDMA and echocardiographic parameters of AS severity before TAVI (p < 0.01 for all).Conclusions: Plasma concentrations of arginine, ADMA, and SDMA were not affected by TAVI and did not predict post-TAVI MACE.ADMA and SDMA negatively correlated with AS severity, which might indicate alterations in the NO/L-arginine pathway in patients with AS.

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