Evaluation of asymmethric dimethylarginine levels in Down syndrome patients with congenital heart disease

Aim: Pulmonary hypertension is a major cause of morbidity and mortality among Down syndrome patients with congenital heart disease. Asymmethric dimethyl arginine (ADMA) is an endogenous inhibitor of nitric oxide synthesis. Increased plasma levels of ADMA may be related with pulmonary hypertension. The aim of this study was to evaluate the relationship between ADMA and pulmonary hypertension in Down syndrome patients with congenital heart disease. Material and Method: The study group consisted of 21 children with Down syndrome with congenital heart disease. Plasma ADMA concentrations were analyzed according to the presence or absence of pulmonary hypertension. Results: The mean age of the 21 patients was 29.7 ±23.5 months (range: 3-88 months). Six patients with congenital heart disease had accompanied with pulmonary hypertension. Fifteen patients had no pulmonary hypertension. The levels of ADMA showed no statistically significant difference between the groups (p >0.05). Conclusion: No correlation was shown between ADMA levels and pulmonary hypertension in children with Down syndrome with congenital heart disease. However, multicenter prospective studies with enlarged sample sized are needed to provide more realistic results about the connection between ADMA and pulmonary hypertension in Down syndrome children