title: Midregional proadrenomedullin reflects cardiac dysfunction in haemodialysis patients with cardiovascular disease.
abstract: BACKGROUND
  Although adrenomedullin is an indicator of cardiac dysfunction in haemodialysis patients, the clinical significance of midregional proadrenomedullin has not been elucidated. Objectives. We evaluated whether midregional proadrenomedullin reflects cardiac dysfunction, systemic inflammation or blood volume in haemodialysis patients.
  
  
  METHODS
  Plasma midregional proadrenomedullin, C-reactive protein and delta body weight (indicating excessive blood volume), and two-dimensional as well as Doppler echocardiographic variables were measured just before haemodialysis in 70 patients with cardiovascular disease.
  
  
  RESULTS
  The median value of midregional proadrenomedullin was 1.93 nmol/l before haemodialysis, and these levels were significantly reduced following haemodialysis. Log [midregional proadrenomedullin] was positively correlated with left ventricular end-systolic volume index, diameter of inferior vena cava, C-reactive protein and delta body weight (r = 0.328, r = 0.421, r = 0.356, r = 0.364), and negatively with blood pressure, deceleration time of an early diastolic filling wave, pulmonary venous flow velocity ratio and left ventricular ejection fraction (r = -0.330, r = -0.324, r = -0.479, r = -0.373). Multivariate regression analysis revealed that pulmonary venous flow velocity ratio, diameter of inferior vena cava and C-reactive protein were independently related factors for midregional proadrenomedullin concentration.
  
  
  CONCLUSIONS
  Plasma midregional proadrenomedullin levels increase in association with cardiac dysfunction, systemic inflammatory status and systemic blood volume in haemodialysis patients with concomitant cardiovascular disease.
authors: Division of Hypertension and Nephrology, National Cardiovascular Center, Suita, Osaka, Japan. fyoshi@ri.ncvc.go.jp
authors: Fumiki
authors: F
authors: Yoshihara
authors: Andrea
authors: A
authors: Ernst
authors: Nils G
authors: NG
authors: Morgenthaler
authors: Takeshi
authors: T
authors: Horio
authors: Satoko
authors: S
authors: Nakamura
authors: Hajime
authors: H
authors: Nakahama
authors: Hiroto
authors: H
authors: Nakata
authors: Andreas
authors: A
authors: Bergmann
authors: Kenji
authors: K
authors: Kangawa
authors: Yuhei
authors: Y
authors: Kawano
mesh_terms: D053607:Adrenomedullin; D000368:Aged; D001810:Blood Volume; D001835:Body Weight; D002097:C-Reactive Protein / Q000096:biosynthesis; D004452:Echocardiography / Q000379:methods; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000150:complications; D006801:Humans; D007249:Inflammation; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D011506:Proteins; D006435:Renal Dialysis
chemical_list: D011498:Protein Precursors; D011506:Proteins; C088633:proadrenomedullin; D053607:Adrenomedullin; D002097:C-Reactive Protein