Non-invasive assessment of coronary flow reserve and ADMA levels: A case - Control study of early rheumatoid arthritis patients

Maurizio Turiel, Fabiola Atzeni, Livio Tomasoni, Simona De Portu, Luigi Delfino, Bruno Dino Bodini, Matteo Longhi, Simona Sitia, Mauro Bianchi, Paolo Ferrario, Andrea Doria, Vito De Gennaro Colonna, Piercarlo Sarzi-Puttini

Research output: Contribution to journalArticlepeer-review


Objective. Plasma concentration of asymmetric dimethylarginine (ADMA), a major endogenous inhibitor of nitric oxide synthase, is considered a novel risk factor for endothelial dysfunction associated with enhanced atherosclerosis. Coronary microcirculation abnormalities have been demonstrated in patients with early rheumatoid arthritis (ERA) without any signs or symptoms of coronary artery disease (CAD). The aim of the study was to compare the ERA and control groups with ADMA, intima-media thickness (IMT) and coronary flow reserve (CFR) levels. It assessed whether ERA patients have more cardiovascular risk (endothelial dysfunction and coronary microvascular abnormalities), and evaluated whether any difference in IMT/CFR between ERA and controls can be explained by any difference in ADMA levels between the groups. Methods.The study involved 25 ERA patients (female/male 21/4; mean age 52.04 ≤ 14.05 years; disease duration ≤12 months) and 25 healthy volunteers with no history or current signs of CAD or other traditional risk factors. Dipyridamole trans-thoracic stress echocardiography was preformed to evaluate CFR, and carotid ultrasound to measure the IMT of the common carotid arteries. Blood samples were obtained in order to assess ADMA levels before the patients had received any biological or non-biological DMARDs, or steroid therapy. Results. CFR was significantly reduced in the ERA patients (2.5 ± 0.5 vs 3.5 ± 0.8; P <0.01). In particular, 6/25 (24%) had a CFR of

Original languageEnglish
Pages (from-to)834-839
Number of pages6
Issue number7
Publication statusPublished - 2009


  • Asymmetric dimethylarginine
  • Coronary artery disease
  • Coronary flow reserve
  • Rheumatoid arthritis
  • Trans-thoracic echocardiography

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)


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