Copyright © 2000 by the European Society of Cardiology.
Plasma adrenomedullin, a new independent predictor of prognosis in patients with chronic heart failure
a Department of Cardiology, Pitié-Salpêtrière Hospital, Paris, France
d Department of Pharmacology, Pitié-Salpêtrière Hospital, Paris, France
b Department of Biochemistry, Pitié-Salpêtrière Hospital, Paris, France
c Department of Biostatistics, Pitié-Salpêtrière Hospital, Paris, France
revised June 29, 1999; accepted August 18, 1999
Abstract
Background Adrenomedullin, a potent endogenous vasodilating and natriuretic peptide, may play an important role in the pathophysiology of chronic heart failure. Plasma levels of immunoreactive adrenomedullin were examined for prediction of prognosis in chronic heart failure.
Methods and Results Plasma levels of immunoreactive-ADM (ir-ADM) were measured by radioimmunoassay in 117 chronic heart failure patients with idiopathic or ischaemic cardiomyopathy (mean ejection fraction: 28±10%, in the NYHA functional class I/II/III/IV:8/73/29/7, and treated with ACE inhibitors and diuretics. Plasma levels of immunoreactive adrenomedullin were significantly increased in chronic heart failure patients by comparison to controls (618±293pg.ml–1vs 480±135pg.ml–1,P =0·01). During the follow-up period (237±137 days) 14 cardiovascular deaths and four urgent cardiac transplantations occurred. In the univariate Cox model, immunoreactive adrenomedullin plasma levels were related to prognosis (P=0·004). A multivariate analysis including heart rate, systolic blood pressure, NYHA class, left ventricular ejection fraction, left ventricular echocardiographic end-diastolic diameter, plasma levels of immunoreactive adrenomedullin, endothelin-1, norepinephrine and atrial natriuretic peptide was performed: plasma levels of immunoreactive adrenomedullin (P=0·03), of endothelin-1 (P=0·0001), and systolic blood pressure (P=0·003) were significantly associated with outcome.
Conclusion Our results suggest that elevated plasma levels of immunoreactive adrenomedullin are an independent predictor of prognosis in predominantly mild to moderate chronic heart failure treated by conventional therapy and provide additional prognostic information.
Key Words: Adrenomedullin, chronic heart failure, prognosis
f1 Correspondence: Prof M. Komajda, Service de Cardiologie, Hôpital Pitié-Salpêtrière, 47–83 Boulevard de l'Hôpital, 75913 Paris, France.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C. Adlbrecht, M. Hulsmann, G. Strunk, R. Berger, D. Mortl, J. Struck, N. G. Morgenthaler, A. Bergmann, J. Jakowitsch, G. Maurer, et al. Prognostic value of plasma midregional pro-adrenomedullin and C-terminal-pro-endothelin-1 in chronic heart failure outpatients Eur J Heart Fail, April 1, 2009; 11(4): 361 - 366. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C E Raphael, Z I Whinnett, J E Davies, M Fontana, E A Ferenczi, C H Manisty, J Mayet, and D P Francis Quantifying the paradoxical effect of higher systolic blood pressure on mortality in chronic heart failure Heart, January 1, 2009; 95(1): 56 - 62. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Taylor, J. R. Baker, and W. K. Samson Brain-derived adrenomedullin controls blood volume through the regulation of arginine vasopressin production and release Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2005; 288(5): R1203 - R1210. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Gardner, V. Chong, I. Morton, and T. A. McDonagh N-terminal brain natriuretic peptide is a more powerful predictor of mortality than endothelin-1, adrenomedullin and tumour necrosis factor-{alpha} in patients referred for consideration of cardiac transplantation Eur J Heart Fail, March 2, 2005; 7(2): 253 - 260. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. T. Rademaker, C. J. Charles, E. A. Espiner, M. G. Nicholls, and A. M. Richards Long-Term Adrenomedullin Administration in Experimental Heart Failure Hypertension, November 1, 2002; 40(5): 667 - 672. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Ceconi, R. Ferrari, T. Bachetti, C. Opasich, M. Volterrani, B. Colombo, G. Parrinello, and A. Corti Chromogranin A in heart failure. A novel neurohumoral factor and a predictor for mortality Eur. Heart J., June 2, 2002; 23(12): 967 - 974. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. Baumer, C. Schumann, B. Cremers, G. Itter, W. Linz, F. Jockenhovel, and M. Bohm Gene expression of adrenomedullin in failing myocardium: comparison to atrial natriuretic peptide J Appl Physiol, March 1, 2002; 92(3): 1058 - 1063. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.G Williams, G.A Cooke, D.J Wright, W.J Parsons, R.L Riley, P Marshall, and L-B Tan Peak exercise cardiac power output; a direct indicator of cardiac function strongly predictive of prognosis in chronic heart failure Eur. Heart J., August 2, 2001; 22(16): 1496 - 1503. [Abstract] [PDF]
|
|