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. 1997 Oct;78(4):390–395. doi: 10.1136/hrt.78.4.390

Plasma concentrations of adrenomedullin correlate with the extent of pulmonary hypertension in patients with mitral stenosis

T Nishikimi 1, S Nagata 1, T Sasaki 1, S Tomimoto 1, H Matsuoka 1, S Takishita 1, K Kitamura 1, A Miyata 1, H Matsuo 1, K Kangawa 1
PMCID: PMC1892251  PMID: 9404257

Abstract

Objective—To examine the pathophysiological significance of adrenomedullin in the pulmonary circulation by investigating the relation between plasma concentrations of adrenomedullin and central haemodynamics in patients with mitral stenosis.
Methods—Plasma concentrations of adrenomedullin in blood samples obtained from the femoral vein, pulmonary artery, left atrium, and aorta were measured by a newly developed specific radioimmunoassay in 23 consecutive patients with mitral stenosis (16 females and seven males, aged 53 (10) years (mean (SD)) who were undergoing percutaneous mitral commissurotomy.
Results—Patients with mitral stenosis had higher concentrations of adrenomedullin than age matched normal controls (3.9 (0.3) v 2.5 (0.3) pmol/l, p < 0.001). There was a reduction in adrenomedullin concentrations between the pulmonary artery and the left atrium (3.8 (0.2) v 3.2 (0.4) pmol/l, p < 0.001). The venous concentrations of adrenomedullin correlated with mean pulmonary artery pressure (r = 0.65, p < 0.001), total pulmonary vascular resistance (r = 0.83, p < 0.0001), and pulmonary vascular resistance (r = 0.65, p < 0.001). Plasma concentrations of adrenomedullin did not change immediately after percutaneous mitral commissurotomy; however, they decreased significantly one week later.
Conclusions—Plasma concentrations of adrenomedullin are increased in patients with mitral stenosis. This may help to attenuate the increased pulmonary arterial resistance in secondary pulmonary hypertension due to mitral stenosis.

 Keywords: adrenomedullin;  pulmonary hypertension;  mitral stenosis;  pulmonary circulation

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Figure 1  .

Figure 1  

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Venous plasma concentrations of adrenomedullin, atrial natriuretic factor (ANF), and brain natriuretic peptide (BNP) in normal controls (N) and patients with mitral stenosis (MS). Values are means, error bars = SEM.

Figure 2  .

Figure 2  

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Plasma concentrations of adrenomedullin, atrial natriuretic factor (ANF), and brain natriuretic peptide (BNP) in femoral vein (V), pulmonary artery (PA), left atrium (LA), and aorta (AO) in patients with mitral stenosis (MS). Values are means, error bars = SEM.

Figure 3  .

Figure 3  

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Scatterplots showing the relations between venous plasma adrenomedullin concentrations and pulmonary vascular resistance, total pulmonary resistance, and mean pulmonary artery pressure in patients with mitral stenosis.

Selected References

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