Background-Adrenomedullin (AM) is expressed in cardiac tissue, and plasma AM levels increase in patients with acute myocardial infarction (MI). This study was performed to determine whether AM administration immediately after acute MI inhibits progression of heart failure in rats. Methods and Results-Rats were infused with 1.0 g/h IP AM or saline over 7 days immediately after MI inducted by left coronary ligation and were examined 9 weeks after MI. Compared with the saline infusion, AM infusion significantly improved survival (59% versus 81%; PϽ0.05) and body weight gain (32%; PϽ0.01) and reduced heart weight (Ϫ28%; PϽ0.01), lung weight (Ϫ26%; PϽ0.01), left ventricular (LV) end-diastolic pressure (11.4Ϯ2.0 versus 4.0Ϯ0.6 mm Hg, meanϮ SEM; PϽ0.01), collagen volume fraction of noninfarcted LV (Ϫ39%; PϽ0.05), and plasma levels of endogenous rat AM (Ϫ38%; PϽ0.05) without affecting infarct size. To investigate the mechanism of AM actions, another series of MI rats infused with AM were killed on day 7. AM infusion had no effect on organ weights and hemodynamic parameters on day 7 of MI but significantly reduced urinary excretion of isoprostane (Ϫ61%; PϽ0.01) and noninfarcted LV mRNA levels of ACE (Ϫ31%; PϽ0.05) and p22-phox (Ϫ30%; PϽ0.05). Conclusions-AM administration during the early period of MI improved the survival and ameliorated progression of LV remodeling and heart failure. This beneficial effect was accompanied by reductions in oxidative stress and ACE mRNA expression in noninfarcted LV in the AM infusion period.

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Continuous administration of AM had beneficial effects on LV remodeling and hemodynamics in MI rats, suggesting the possibility that this peptide could be a useful therapeutic tool for acute MI.

We report five cases of absence of the left liver lobe diagnosed by ultrasonography (US) and/or computed tomography (CT). There were four men and one woman, with an average age of 62.8 years. The right lobe was normal in four patients and enlarged in one. A tongue-like hypertrophy of the caudate lobe was present in two patients. The gallbladder was located at the left portion of the liver. Elevation of the antrum of the stomach was also seen.

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