Abstract
Recently, L-arginine reactivity has been used for evaluation of cerebral endothelial
impairment. However, the diagnostic potential of the method is still unknown. The
aim of the study was to establish the sensitivity and specificity of L-arginine reactivity
and compare this method with flow-mediated dilation (FMD) and intima-media thickness
(IMT). L-arginine reactivity, FMD and IMT were determined in patients with arterial
hypertension (AH) and presumed endothelial impairment (41 patients, aged 60.9 ± 7.4
y) and 21 age- and gender-matched healthy controls. The relative increase in the mean
arterial velocity after a 30-min i.v. infusion of L-arginine (dvm(L-arg)) was ascertained by TCD. FMD of the brachial artery after hyperaemia and IMT of the
common carotid artery on both sides were determined. The diagnostic value of the methods
was assessed using receiver-operating-characteristic (ROC) analysis. In patients with
AH, dvm(L-arg), FMD and IMT were diminished (11.5% ± 8.9%; 3.8% ± 4.8%; 0.82 ± 0.16 mm) compared
with the healthy controls (20.5% ± 9.9%; 7.9% ± 6.0%;0.64 ± 0.15 mm) (p ≤ 0.01). The optimal cut-point for L-arginine reactivity of 0.22 yielded a 40% sensitivity
and 93% specificity, which was comparable to the other two methods. For all three
methods, the area under the ROC curves differed significantly from 0.5 (0.694; p = 0.013 for dvm(L-arg), 0.784; p ≤ 0.01 for FMD, 0.827; p ≤ 0.01 for IMT). Cerebrovascular reactivity to L-arginine is a valuable method for
determination of cerebral endothelial function. The diagnostic value of the three
methods is comparable. (E-mail: [email protected])
Key Words
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Article info
Publication history
Published online: July 09, 2007
Accepted:
April 16,
2007
Received in revised form:
February 22,
2007
Received:
November 21,
2006
Identification
Copyright
© 2007 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
