Increased pericardial fluid concentrations of the mature form of adrenomedullin in patients with cardiac remodelling. Issue 3 (1st March 2002)

• Record Type: Journal Article
• Authors: Tambara, K; Fujita, M; Nagaya, N; Miyamoto, S; Iwakura, A; Doi, K; Sakaguchi, G; Nishimura, K; Kangawa, K; Komeda, M
• Is Part Of: Heart. Volume 87:Issue 3(2002)
• Page Start: 242
• Page End: 246
• Publication Date: 2002-03-01
• Subjects: adrenomedullin -- cardiac remodelling -- heart failure -- pericardial fluid; iAM, intermediate form of adrenomedullin -- LVEDP, left ventricular end diastolic pressure -- LVEDVI, left ventricular end diastolic volume index -- LVEF, left ventricular ejection fraction -- LVESVI, left ventricular end systolic volume index -- LVMI, left ventricular mass index -- mAM, mature adrenomedullin -- tAM, total immunoreactive adrenomedullin; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heart.87.3.242
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: There is evidence that adrenomedullin has autocrine or paracrine activities that oppose cardiac remodelling. However, it remains unclear whether it exerts those local functions in heart failure patients. Objective: To investigate the relation between plasma and pericardial fluid concentrations of adrenomedullin and left ventricular haemodynamic variables. Design: Samples of plasma and pericardial fluid were obtained from 50 patients undergoing cardiac surgery. They were classified into two groups: group N (n = 27) with a left ventricular end diastolic volume index (LVEDVI) ≤ 90 ml/m 2 ; and group R (n = 23) with LVEDVI > 90 ml/m 2 . Plasma and pericardial fluid concentrations of total adrenomedullin (tAM) and mature adrenomedullin (mAM) were measured and related to the preoperative haemodynamic variables. Results: Pericardial fluid concentrations of mAM were much higher than the plasma concentration in both group N and group R (mean (SEM), 10.6 (1.7) v 3.3 (0.2) fmol/ml, p = 0.0001; and 21.2 (2.8) v 3.9 (0.3) fmol/ml, p < 0.0001, respectively). The ratio mAM/tAM in pericardial fluid was significantly higher than in plasma (0.56 (0.02) v 0.28 (0.02), p < 0.0001). Pericardial fluid concentrations of mAM, but not plasma concentrations, were significantly correlated with LVEDVI, left ventricular end systolic volume index, left ventricular ejection fraction, and left ventricular mass index ( r = 0.60, 0.63, −0.54, and 0.47, respectively). Conclusions: Raised pericardial fluid concentrations of mAM may reflect the actions of adrenomedullin as a local mediator against cardiac remodelling in patients with left ventricular dysfunction.