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Horm Metab Res 2002; 34(2): 81-86
DOI: 10.1055/s-2002-20520
Original Clinical

© Georg Thieme Verlag Stuttgart · New York

Cessation of Pulmonary and Coronary Secretion of Adrenomedullin Peptides in the Progression of Human Heart Failure

K.  Stangl 1 , T.  Dschietzig 1 , C.  Richter 1 , V.  Stangl 1 , C.  Bartsch 1 , H.  R.  Zurbrügg 2 , R.  Pregla 2 , G.  Baumann 1 , S.  B.  Felix 1 , M.  Laule 1
  • 1 Medizinische Klinik m. S. Kardiologie, Angiologie, Pulmologie Charité (Campus Mitte), Humboldt-Universität zu Berlin, Germany
  • 2 German Heart Institute, Berlin, Germany
Further Information

Publication History

7 June 2001

8 November 2001

Publication Date:
04 March 2002 (online)

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Abstract

In human heart failure (CHF), adrenomedullin (AM) counteracts vasoconstriction and sodium retention. We investigated circulating levels of proadrenomedullin N-20 peptide (PAMP) and AM, and left ventricular expression of preproAM and calcitonin receptor-like receptor (CRLR) mRNA. Peptide levels were determined from the left ventricle, pulmonary artery, coronary sinus, and antecubital vein in patients demonstrating severe CHF (n = 12; mean ± SEM cardiac index, 1.9 ± 0.2 l/min/m2; pulmonary wedge pressure, 32 ± 1 mmHg), moderate CHF (n = 11; cardiac index, 2.9 ± 0.2; pulmonary wedge pressure, 14 ± 2), and in controls (n = 11). Left ventricular mRNA was quantified using RT-PCR and Southern blot hybridization. Depending on sites of measurement, PAMP and AM in severe CHF were 1.3 - 2.0 and 1.2 - 1.9 times as high as in moderate CHF, and 3.8 - 4.6 and 2.3 - 2.8 times as high as in controls. Only patients with moderate CHF demonstrated pulmonary and coronary net release of both peptides, that is, significant step-ups in concentrations between the pulmonary artery, left ventricle, and coronary sinus. In failing ventricles, preproAM mRNA increased 2.9 times above control, but CRLR mRNA was unchanged. Altogether, the heart and the lungs release AM peptides in moderate CHF. This secretion breaks down in severe CHF: a process that may contribute to and indicate decompensation. Unlike AM, the CRLR is not transcriptionally upregulated in severe CHF.

Key words

Hemodynamics - Catheterization - Radioimmunoassay - mRNA - Receptors

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Karl Stangl, M.D.

Medizinische Klinik und Poliklinik mit Schwerpunkt Kardiologie, Angiologie und Pulmologie · Charité (Campus Mitte), Humboldt-Universität zu Berlin

Schumannstraße 20/21 · 10098 Berlin · Germany

Phone: + 49 (30) 450-513 075/153

Fax: + 49 (30) 450-513 932

Email: karl.stangl@charite.de