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. 1998 Jan;79(1):39–44. doi: 10.1136/hrt.79.1.39

Increased plasma adrenomedullin levels in patients with acute myocardial infarction in proportion to the clinical severity

Y Miyao 1, T Nishikimi 1, Y Goto 1, S Miyazaki 1, S Daikoku 1, I Morii 1, T Matsumoto 1, S Takishita 1, A Miyata 1, H Matsuo 1, K Kangawa 1, H Nonogi 1
PMCID: PMC1728561  PMID: 9505917

Abstract

Objectives—To investigate the pathophysiological role of adrenomedullin in myocardial infarction.
Patients and design—Plasma concentrations of adrenomedullin, atrial natriuretic factor, and brain natriuretic peptide were measured by radioimmunoassay in 31 patients with acute myocardial infarction over four weeks, and in 44 normal subjects.
Results—In patients with acute myocardial infarction, plasma adrenomedullin reached a peak of (mean (SD) 14.0 (9.0) pmol/l at 24 hours after the onset of symptoms and remained increased at all sampling points except the four week point compared with the value in normal subjects (5.0 (2.0) pmol/l). Adrenomedullin concentrations on admission were higher in patients from Killip class II, III, and IV than class I, and correlated positively with peak plasma creatine kinase and left ventricular end diastolic volume index, and negatively with left ventricular ejection fraction. The values from 12 to 48 hours were negatively correlated with systemic vascular resistance index. During the time course studied, adrenomedullin concentrations were positively correlated with atrial natriuretic factor (r = 0.40, p < 0.001) and brain natriuretic peptide (r = 0.53, p < 0.001).
Conclusions—Plasma adrenomedullin concentrations increased in the acute phase of myocardial infarction in proportion with clinical severity, suggesting that adrenomedullin may play an important role in the pathophysiology of myocardial infarction.

 Keywords: adrenomedullin;  acute myocardial infarction;  natriuretic peptides

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Figure 1  .

Figure 1  

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(A) Plots of plasma adrenomedullin in patients with acute myocardial infarction and in normal control subjects. Values are means, error bars = SEM. ‡p<0.05, ‡‡p<0.01 v values at 4 weeks. (B) Plots of plasma atrial natriuretic factor (ANF) and brain natriuretic peptide (BNP) in patients with acute myocardial infarction and in normal control subjects. Values are means, error bars = SEM. †p<0.01 v values of ANF on admission; §p<0.05, §§p<0.01 v values of BNP on admission. *p<0.01 v control values.

Figure 2  .

Figure 2  

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(A) Plasma adrenomedullin concentrations according to the Killip classification on admission in patients with acute myocardial infarction. Mean plasma adrenomedullin in Killip class II, III, and IV was significantly higher than in Killip class I. (B) Plasma adrenomedullin according to the Forrester subsets on admission in patients with acute myocardial infarction. Mean plasma adrenomedullin in Forrester subsets III and IV was significantly higher than in Forrester subsets I and II. Values are means (SEM).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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