Azouaou Leila, Adnane Mounir, Khelfi Abedrrezak, Chader Henni, Seba Atmene
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We studied the correlation between the mean values of iNOS and ADMA in CKD patients and its relationship with left ventricular hypertrophy and the benefit of treating these patients with an associated ACEI and Vit C.</p><p><strong>Results: </strong>The mean age of the patients was 58.85 ±12.75 years. The mean values of iNOS and ADMA were 63.92 ± 0.59 μmol/l and 16.77 ±0.91 μmol/l, respectively. These values increased significantly with the degradation of the renal function (<i>p</i> < 0.05). A significant positive correlation was found between the left ventricular mass index (LVMI) and the two markers, ADMA (0.901 and <i>p</i> = 0001) and iNOS (0.718 and <i>p</i> = 0.0001). After 2 years of treatment with Vit C and ACEI, a significant decrease in LVMI was observed.</p><p><strong>Conclusions: </strong>NO secreted by the iNOS system and ADMAs initiates cardiac remodeling to lead to left ventricular hypertrophy and cardiac fibrosis. ACEIs increase the expression and activity of eNOS and decrease iNOS. Vit C prevents oxidative damage by scavenging ROS species and reagents nitrogen while. iNOS and ADMA accelerate cardiac aging. We conclude that ACEIs combined with Vit C may improve heart health and limite left ventricular hypertrophy in CKD patients.</p>","PeriodicalId":8317,"journal":{"name":"Archives of Medical Sciences. 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引用次数: 1
摘要
诱导型一氧化氮(iNOS)是由细胞因子和内毒素诱导产生的。内皮细胞一氧化氮(NO)分泌的一氧化氮(NO)的心脏保护作用依赖于精氨酸。精氨酸的产生主要发生在机体内，肾脏在其合成和不对称二甲基精氨酸(ADM)的消除中起着关键作用。本研究探讨了慢性肾脏疾病(CKD)患者iNOS、ADMA与左心室肥厚的关系，以及血管紧张素转换酶抑制剂(ACEI)联合维生素C (Vit C)治疗的效果。材料与方法:对153例慢性肾病患者进行纵向观察研究。我们研究了CKD患者iNOS和ADMA均值与左室肥厚的相关性及其与左室肥厚的关系，以及合并ACEI和Vit c治疗这些患者的获益。结果:患者平均年龄58.85±12.75岁。iNOS和ADMA的平均值分别为63.92±0.59 μmol/l和16.77±0.91 μmol/l。随着肾功能的退化，这些数值显著升高(p < 0.05)。左室质量指数(LVMI)与ADMA (0.901, p = 0001)、iNOS (0.718, p = 0.0001)呈显著正相关。经Vit C和ACEI治疗2年后，LVMI明显降低。结论:一氧化氮通过iNOS系统和ADMAs分泌引发心脏重构，导致左室肥厚和心肌纤维化。ACEIs增加eNOS的表达和活性，降低iNOS。维生素C通过清除活性氧和试剂氮来防止氧化损伤。iNOS和ADMA加速心脏老化。我们得出结论，acei联合Vit C可以改善CKD患者的心脏健康并限制左心室肥厚。
Revitalizing cardiac health in chronic renal failure: the synergistic effects of angiotensin-converting enzyme inhibitors and vitamin C in modulating nitric oxide and left ventricular hypertrophy.
Introduction: The inducible form of nitric oxide (iNOS) is induced by cytokines and endotoxins. The cardiac-protective effects of nitric oxide (NO) secreted by endothelial NOS are dependent on arginine. Arginine production occurs mainly within the organism, with the kidneys playing a key role in its synthesis and the elimination of asymmetric dimethylarginine (ADM). In the present study the relationship between iNOS, ADMA and left ventricular hypertrophy in chronic kidney disease (CKD) patients and the effect of treatment with angiotensin converting enzyme inhibitor (ACEI) associated with vitamin C (Vit C) were investigated.
Material and methods: A longitudinal observational study was conducted on 153 patients with CKD. We studied the correlation between the mean values of iNOS and ADMA in CKD patients and its relationship with left ventricular hypertrophy and the benefit of treating these patients with an associated ACEI and Vit C.
Results: The mean age of the patients was 58.85 ±12.75 years. The mean values of iNOS and ADMA were 63.92 ± 0.59 μmol/l and 16.77 ±0.91 μmol/l, respectively. These values increased significantly with the degradation of the renal function (p < 0.05). A significant positive correlation was found between the left ventricular mass index (LVMI) and the two markers, ADMA (0.901 and p = 0001) and iNOS (0.718 and p = 0.0001). After 2 years of treatment with Vit C and ACEI, a significant decrease in LVMI was observed.
Conclusions: NO secreted by the iNOS system and ADMAs initiates cardiac remodeling to lead to left ventricular hypertrophy and cardiac fibrosis. ACEIs increase the expression and activity of eNOS and decrease iNOS. Vit C prevents oxidative damage by scavenging ROS species and reagents nitrogen while. iNOS and ADMA accelerate cardiac aging. We conclude that ACEIs combined with Vit C may improve heart health and limite left ventricular hypertrophy in CKD patients.
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