Increased pericardial fluid concentrations of the mature form of adrenomedullin in patients with cardiac remodelling.
BACKGROUND
There is evidence that adrenomedullin has autocrine or paracrine activities that oppose cardiac remodelling. However, it remains unclear whether it exerts those local functions in heart failure patients.


OBJECTIVE
To investigate the relation between plasma and pericardial fluid concentrations of adrenomedullin and left ventricular haemodynamic variables.


METHODS
Samples of plasma and pericardial fluid were obtained from 50 patients undergoing cardiac surgery. They were classified into two groups: group N (n = 27) with a left ventricular end diastolic volume index (LVEDVI) < or = 90 ml/m(2); and group R (n = 23) with LVEDVI > 90 ml/m(2). Plasma and pericardial fluid concentrations of total adrenomedullin (tAM) and mature adrenomedullin (mAM) were measured and related to the preoperative haemodynamic variables.


RESULTS
Pericardial fluid concentrations of mAM were much higher than the plasma concentration in both group N and group R (mean (SEM), 10.6 (1.7) v 3.3 (0.2) fmol/ml, p = 0.0001; and 21.2 (2.8) v 3.9 (0.3) fmol/ml, p < 0.0001, respectively). The ratio mAM/tAM in pericardial fluid was significantly higher than in plasma (0.56 (0.02) v 0.28 (0.02), p < 0.0001). Pericardial fluid concentrations of mAM, but not plasma concentrations, were significantly correlated with LVEDVI, left ventricular end systolic volume index, left ventricular ejection fraction, and left ventricular mass index (r = 0.60, 0.63, -0.54, and 0.47, respectively).


CONCLUSIONS
Raised pericardial fluid concentrations of mAM may reflect the actions of adrenomedullin as a local mediator against cardiac remodelling in patients with left ventricular dysfunction.
Tambara
K
K
Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Fujita
M
M
Nagaya
N
N
Miyamoto
S
S
Iwakura
A
A
Doi
K
K
Sakaguchi
G
G
Nishimura
K
K
Kangawa
K
K
Komeda
M
M
D053607:Adrenomedullin; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000378:metabolism / Q000601:surgery; D015415:Biomarkers / Q000032:analysis; D001826:Body Fluids / Q000737:chemistry; D005260:Female; D006331:Heart Diseases / Q000378:metabolism / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000378:metabolism*; D010496:Pericardium / Q000737:chemistry*; D018487:Ventricular Dysfunction, Left / Q000378:metabolism / Q000601:surgery; D020257:Ventricular Remodeling / Q000502:physiology*
D015415:Biomarkers; D010455:Peptides; D053607:Adrenomedullin