Relationship Between L-arginine/asymmetric Dimethylarginine, Homocysteine, Folic Acid, Vitamin B Levels, and Coronary Artery Ectasia

Background Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. The ratio of L-arginine/asymmetric dimethylarginine (ADMA) and homocysteine are important factors for endothelial function. In this study, we investigate the ratio of L-arginine/ADMA, homocysteine, and folic acid/vitamin B levels in patients with CAE. Methods Forty patients diagnosed with CAE using coronary angiography were included in the study (24 male; mean age, 56 +/- 11 years). The control group consisted of 30 patients who had normal coronary arteries as determined by coronary angiography (11 male; mean age, 54 +/- 8 years). The ratio of L-arginine/ADMA and plasma homocysteine was measured using high-performance liquid chromatography. Results The L-arginine/ADMA ratio and L-arginine levels were significantly lower in the CAE group compared with the control group (110 +/- 27 vs. 149 +/- 77, P = 0.02 and 157 +/- 32 mu mol/l vs. 187 +/- 59 mu mol/l, P = 0.02, respectively). Plasma ADMA levels were similar in the two groups. Patients with CAE had higher plasma homocysteine levels (P = 0.01). Plasma folic acid, vitamin B6, and vitamin B12 levels were similar between the two groups. Conclusion This study shows that patients with CAE have a lower L-arginine/ADMA ratio and higher plasma homocysteine levels. These results show a potential relationship between endothelial dysfunction and CAE.