Haemodynamic and hormonal effects of adrenomedullin in patients with pulmonary hypertension.
OBJECTIVE
To investigate whether infusion of adrenomedullin, a potent vasorelaxant peptide, has beneficial haemodynamic and hormonal effects in patients with pulmonary hypertension.


METHODS
The haemodynamic and hormonal responses to intravenous infusion of adrenomedullin (0.05 microgram/kg/min) or placebo were examined in 13 patients with precapillary pulmonary hypertension.


RESULTS
Infusion of adrenomedullin produced a 44% increase in cardiac index (mean (SD) 1.8 (0.2) to 2.6 (0.3) l/min/m(2), p < 0. 05) and a 32% decrease in pulmonary vascular resistance (19.7 (1.4) to 13.4 (1.3) units, p < 0.05), with a 4% reduction in mean pulmonary arterial pressure (62 (4) to 59 (4) mm Hg, NS). Adrenomedullin also decreased mean systemic arterial pressure (81 (3) to 72 (4) mm Hg, p < 0.05) and increased heart rate (73 (4) to 79 (4) beats/min, p < 0.05). Adrenomedullin decreased plasma aldosterone (9.8 (2.5) to 7.1 (1.5) ng/dl, p < 0.05) without significant changes in plasma renin activity. Plasma atrial and brain natriuretic peptides tended to decrease with adrenomedullin, although these changes did not reach significance. The haemodynamic and hormonal variables remained unchanged during placebo infusion.


CONCLUSIONS
Intravenous adrenomedullin has beneficial haemodynamic and hormonal effects in patients with precapillary pulmonary hypertension.
Nagaya
N
N
Division of Cardiology, Department of Medicine, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565, Japan. nnagaya@hsp.ncvc.go.jp
Nishikimi
T
T
Uematsu
M
M
Satoh
T
T
Oya
H
H
Kyotani
S
S
Sakamaki
F
F
Ueno
K
K
Nakanishi
N
N
Miyatake
K
K
Kangawa
K
K
D053607:Adrenomedullin; D000328:Adult; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006728:Hormones / Q000097:blood; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000494:pharmacology / Q000627:therapeutic use*; D016037:Single-Blind Method; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D006728:Hormones; D010455:Peptides; D014665:Vasodilator Agents; D053607:Adrenomedullin