Decreased Endogenous Nitric Oxide Production in Patients with Acute Decompensated Heart Failure with Preserved Ejection Fraction

Abstract

Background: Heart failure with a preserved ejection fraction (HFpEF) accounts for approximately 50% of patients with heart failure. Endothelial dysfunction has been documented in HFpEF, and impaired nitric oxide (NO) production may be a contributing factor in patients decompensating from chronic to acute HFpEF. Plasma nitrite (NO2−), but not plasma nitrate (NO3−), is highly reflective of local nitric oxide production. However, plasma NO2− levels in relation to chronic and acute HFpEF patients have not been studied. Methods: Plasma NO2− and NO3− concentrations were quantified with gas-phase chemiluminescence. Plasma asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO production,..