Hemodynamic, renal, and hormonal effects of adrenomedullin infusion in patients with congestive heart failure

被引:215
作者
Nagaya, N
Saloh, T
Nishikimi, T
Uematsu, M
Furuichi, S
Sakamaki, F
Oya, H
Kyotani, S
Nakanishi, N
Goto, Y
Masuda, Y
Miyatake, K
Kangawa, K
机构
[1] Natl Cardiovasc Ctr, Dept Internal Med, Suita, Osaka 5658565, Japan
[2] Natl Cardiovasc Ctr, Inst Res, Suita, Osaka 5658565, Japan
[3] Osaka Police Hosp, Div Cardiovasc, Osaka, Japan
[4] Chiba Univ, Sch Med, Dept Internal Med 3, Chiba 280, Japan
关键词
heart failure; hemodynamics; cardiac output; natriuretic peptides;
D O I
10.1161/01.CIR.101.5.498
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Experimental studies have shown that adrenomedullin (AM) causes vasodilatation, diuresis, and a positive inotropic effect. In humans, however, whether infusion of AM has beneficial effects in congestive heart failure (CHF) remains unknown. Methods and Results- Hemodynamic, renal, and hormonal responses to intravenous infusion of human AM (0.05 mu g kg(-1) min(-1)) were examined in 7 patients with CHF and 7 normal healthy subjects (NL). In NL group, AM significantly decreased mean arterial pressure (-16 mm Hg, P<0.05) and increased heart rate (+12 bpm, P<0.05). In CHF group, AM also decreased mean arterial pressure (-8 mm Hg, P<0.05) and increased heart rate (+5 bpm, P<0.05), but to a much lesser degree (P<0.05 versus NL). AM markedly increased cardiac index (CHF, +49%; NL, + 39%, P<0.05) while decreasing pulmonary capillary wedge pressure (CHF, -4 mm Hg; NL, -2 mm Hg, P<0.05). AM significantly decreased mean pulmonary arterial pressure only in CHF (-4 mm Hg, P<0.05). AM increased urine volume (CHF, +48%; NL, +62%, P<0.05) and urinary sodium. excretion (CHF, +42%; NL, +75%, p<0.05). Only in CHF, plasma aldosterone significantly decreased during (-28%, P<0.05) and after (-36%, P<0.05) AM infusion. These parameters remained unchanged in 7 patients with CHF and 6 healthy subjects who received placebo. Conclusions-Intravenous infusion of AM has beneficial hemodynamic and renal effects in patients with CHF. (Circulation. 2000;101:498-503.).
引用
收藏
页码:498 / 503
页数:6
相关论文
共 24 条
[1]   Effect of adrenomedullin on cAMP levels along the rat nephron: Comparison with CGRP [J].
Edwards, RM ;
Trizna, W ;
Stack, E ;
Aiyar, N .
AMERICAN JOURNAL OF PHYSIOLOGY-RENAL FLUID AND ELECTROLYTE PHYSIOLOGY, 1996, 271 (04) :F895-F899
[2]   ULTRASENSITIVE METHOD FOR SIMULTANEOUS DETERMINATION OF CYCLIC-AMP AND CYCLIC-GMP IN SMALL-VOLUME SAMPLES FROM BLOOD AND TISSUE [J].
HONMA, M ;
SATOH, T ;
TAKEZAWA, J ;
UI, M .
BIOCHEMICAL MEDICINE, 1977, 18 (03) :257-273
[3]   ADRENOMEDULLIN STIMULATES CYCLIC-AMP FORMATION IN RAT VASCULAR SMOOTH-MUSCLE CELLS [J].
ISHIZAKA, Y ;
ISHIZAKA, Y ;
TANAKA, M ;
KITAMURA, K ;
KANGAWA, K ;
MINAMINO, N ;
MATSUO, H ;
ETO, T .
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 1994, 200 (01) :642-646
[4]   ELEVATION OF CIRCULATING AND VENTRICULAR ADRENOMEDULLIN IN HUMAN CONGESTIVE-HEART-FAILURE [J].
JOUGASAKI, M ;
WEI, CM ;
MCKINLEY, LJ ;
BURNETT, JC .
CIRCULATION, 1995, 92 (03) :286-289
[5]   ADRENOMEDULLIN - A NOVEL HYPOTENSIVE PEPTIDE ISOLATED FROM HUMAN PHEOCHROMOCYTOMA [J].
KITAMURA, K ;
KANGAWA, K ;
KAWAMOTO, M ;
ICHIKI, Y ;
NAKAMURA, S ;
MATSUO, H ;
ETO, T .
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 1993, 192 (02) :553-560
[6]   Adrenomedullin: A hypotensive hormone in man [J].
Lainchbury, JG ;
Cooper, GJS ;
Coy, DH ;
Jiang, NY ;
Lewis, LK ;
Yandle, TG ;
Richards, AM ;
Nicholls, MG .
CLINICAL SCIENCE, 1997, 92 (05) :467-472
[7]   ADRENOMEDULLIN DILATES THE PULMONARY VASCULAR BED IN-VIVO [J].
LIPPTON, H ;
CHANG, JK ;
HAO, QZ ;
SUMMER, W ;
HYMAN, AL .
JOURNAL OF APPLIED PHYSIOLOGY, 1994, 76 (05) :2154-2156
[8]   Renal responses to intra-arterial administration of adrenomedullin in dogs [J].
Majid, DSA ;
Kadowitz, PJ ;
Coy, DH ;
Navar, LG .
AMERICAN JOURNAL OF PHYSIOLOGY-RENAL FLUID AND ELECTROLYTE PHYSIOLOGY, 1996, 270 (01) :F200-F205
[9]   Circulating adrenomedullin does not regulate systemic blood pressure but increases plasma prolactin after intravenous infusion in humans: A pharmacokinetic study [J].
Meeran, K ;
OShea, D ;
Upton, PD ;
Small, CJ ;
Ghatei, MA ;
Byfield, PH ;
Bloom, SR .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1997, 82 (01) :95-100
[10]   Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension [J].
Nagaya, N ;
Nishikimi, T ;
Okano, Y ;
Uematsu, M ;
Satoh, T ;
Kyotani, S ;
Kuribayashi, S ;
Hamada, S ;
Kakishita, M ;
Nakanishi, N ;
Takamiya, M ;
Kunieda, T ;
Matsuo, H ;
Kangawa, K .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 31 (01) :202-208