Document Detail


Adrenomedullin plasma levels predict left ventricular reverse remodeling after cardiac resynchronization therapy.
MedLine Citation:
PMID:  20230463     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Increase in adrenomedullin (ADM) plasma levels in congestive heart failure (HF) patients is due to many cardiac and systemic factors, particularly to greater fluid retention and to activation of sympathetic nervous system. Aim of this study was to assess the role of plasma ADM levels in HF patients treated by cardiac resynchronization therapy (CRT).
METHODS: 50 patients, mean age 70 years, 34 male, New York Heart Association (NYHA) Class III-IV HF, left ventricular ejection fraction (LVEF) < 35%, underwent CRT. All patients were in sinus rhythm and with complete left bundle branch block (QRS duration 138 +/- 6 msec). A complete echoDoppler exam, blood samples for brain natriuretic peptide (BNP), and ADM were obtained from 2 to 7 days before implantation.
RESULTS: At 16 +/- 6 months follow-up, >or=1 NYHA Class improvement was observed in 38 patients. However, a >10% reduction in end-systolic dimensions (ESD) was reported in 21 patients (Group I): -16.6 +/- 1.8%; in the remaining 29 patients ESD change was almost negligible: -2.0 +/- 1.03% (Group II), P < 0.0001. The two groups were comparable for age, sex, cause of LV dysfunction, therapy, QRS duration at baseline, preimplantation ESD, LVEF%, and BNP. Significantly higher pre implantation ADM levels were present in Group I than in Group II (27.2 +/- 1.8 pmol/l vs 17.9 +/- 1.4, P = 0.0003).
CONCLUSIONS: Significantly higher ADM levels indicate a subgroup of patients in whom reverse remodeling can be observed after CRT. Patients with lower ADM basal values before CRT could represent a group in whom the dysfunction is so advanced that no improvement can be expected.
Authors:
Maria-Aurora Morales; Maristella Maltinti; Marcello Piacenti; Stefano Turchi; Daniela Giannessi; Silvia Del Ry
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-03-08
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  865-72     Citation Subset:  IM    
Affiliation:
CNR Institute of Clinical Physiology and G. Monasterio Foundation, Pisa, Italy. morales@ifc.cnr.it
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MeSH Terms
Descriptor/Qualifier:
Adrenomedullin / blood*
Aged
Aged, 80 and over
Biological Markers / blood
Cardiac Pacing, Artificial / methods*
Female
Heart Failure / blood,  diagnosis*,  prevention & control*
Humans
Male
Middle Aged
Outcome Assessment (Health Care) / methods
Reproducibility of Results
Sensitivity and Specificity
Treatment Outcome
Ventricular Dysfunction, Left / blood,  diagnosis*,  prevention & control*
Ventricular Remodeling
Chemical
Reg. No./Substance:
0/Biological Markers; 148498-78-6/Adrenomedullin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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