Adrenomedullin, a potent hypotensive peptide, reduces blood pressure and pulmonary vascular resistance, and increases pulmonary blood flow. The mRNA for adrenomedullin and its receptor is highly expressed in the lung, suggesting a regulatory role for adrenomedullin in the pulmonary circulation. To investigate the clinical significance of adrenomedullin in patients with pulmonary hypertension, we studied the relationship between plasma levels of adrenomedullin and pulmonary haemodynamics. Venous, arterial and pulmonary arterial blood samples were obtained during cardiac catheterization and plasma levels of adrenomedullin were measured by specific radioimmunoassay in 33 consecutive patients with severe pulmonary hypertension (12 cases of primary pulmonary hypertension, 21 with chronic thromboembolic pulmonary hypertension; age 49±16 years, mean pulmonary arterial pressure 50±15 mmHg). In addition, plasma levels of adrenomedullin were measured before and after acute nitric oxide inhalation. The changes in plasma adrenomedullin during the follow-up period of 10.3±4.3 months were also evaluated (n ;= ;5). Sixty-two healthy subjects served as the control group. Adrenomedullin was measured in an antecubital vein in the controls. Plasma levels of adrenomedullin were significantly higher in the patients with pulmonary hypertension than in the control subjects (10.1±8.7 versus 4.9±1.1 pmol/l, P< 0.01). Plasma levels of adrenomedullin, expressed as their natural logarithm, were significantly correlated with mean right atrial pressure (r ;= ;0.71, P< 0.01), stroke volume (r ;=-0.63, P< 0.01), total pulmonary resistance (r ;= ;0.60, P< 0.01), mean pulmonary arterial pressure (r ;= ;0.37, P< 0.05), and the natural logarithm of plasma atrial natriuretic peptide (r ;= ;0.63, P< 0.01). Plasma levels of adrenomedullin did not change significantly after nitric oxide inhalation, but significantly increased in association with the elevation of the total pulmonary resistance during the long-term follow-up period. These results suggest that plasma levels of adrenomedullin increase in proportion to the extent of pulmonary hypertension.
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January 01 1999
Increased plasma levels of adrenomedullin in patients with pulmonary hypertension
Mikio KAKISHITA;
Mikio KAKISHITA
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
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Toshio NISHIKIMI;
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
Correspondence: Dr T. Nishikimi.
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Yoshiaki OKANO;
Yoshiaki OKANO
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
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Toru SATOH;
Toru SATOH
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
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Shingo KYOTANI;
Shingo KYOTANI
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
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Noritoshi NAGAYA;
Noritoshi NAGAYA
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
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Kengo FUKUSHIMA;
Kengo FUKUSHIMA
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
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Norifumi NAKANISHI;
Norifumi NAKANISHI
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
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Shuichi TAKISHITA;
Shuichi TAKISHITA
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
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Atsuro MIYATA;
Atsuro MIYATA
*Research Institute, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565-0873, Japan
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Kenji KANGAWA;
Kenji KANGAWA
*Research Institute, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565-0873, Japan
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Hisayuki MATSUO;
Hisayuki MATSUO
*Research Institute, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565-0873, Japan
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Takeyoshi KUNIEDA
Takeyoshi KUNIEDA
1Division of Medicine, National Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565, Japan
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Publisher: Portland Press Ltd
Received:
February 02 1998
Revision Received:
July 28 1998
Accepted:
August 11 1998
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 1999
1999
Clin Sci (Lond) (1998) 96 (1): 33–39.
Article history
Received:
February 02 1998
Revision Received:
July 28 1998
Accepted:
August 11 1998
Citation
Mikio KAKISHITA, Toshio NISHIKIMI, Yoshiaki OKANO, Toru SATOH, Shingo KYOTANI, Noritoshi NAGAYA, Kengo FUKUSHIMA, Norifumi NAKANISHI, Shuichi TAKISHITA, Atsuro MIYATA, Kenji KANGAWA, Hisayuki MATSUO, Takeyoshi KUNIEDA; Increased plasma levels of adrenomedullin in patients with pulmonary hypertension. Clin Sci (Lond) 1 January 1998; 96 (1): 33–39. doi: https://doi.org/10.1042/cs0960033
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