MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH

Kolditz, Martin; Wilkens, Heinrike; Ewert, Ralf; Bollmann, Tom; Dinter, Christiane; Hertel, Sabine; Klose, Hans; Opitz, Christian; Grünig, Ekkehard; Höffken, G.; Halank, Michael

doi:10.1007/s00408-015-9802-y

Cited by 14 publications

(21 citation statements)

References 50 publications

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“…showed that plasma MR-proADM correlated to exercise capacity (6MWD and peak oxygen consumption) and was also related to one-year mortality, which remained valid when investigating each subgroup alone. 19…”

Section: Discussionmentioning

confidence: 99%

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Plasma adrenomedullin peptides and precursor levels in pulmonary arterial hypertension disease severity and risk stratification

Bouzina¹,

Rådegran²

2020

Pulm. circ.

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Adrenomedullin is a potent vasodilatory peptide, linked to pulmonary arterial hypertension pathology. Proximity extension assays were utilized to study plasma biomarkers related to vasoregulation, with focus on adrenomedullin peptides and precursor levels, collectively referred to as ADM. ADM was measured in 48 treatment-naïve pulmonary arterial hypertension patients at diagnosis, and in 31 of them at an early treatment follow-up. Plasma ADM was additionally assessed in patients with chronic thromboembolic pulmonary hypertension ( n = 20) and pulmonary hypertension due to heart failure with preserved (HFpEF(PH)) ( n = 33) or reduced (HFrEF(PH)) ( n = 36) ejection fraction, as well as healthy controls ( n = 16). ADM was studied in relation to pulmonary arterial hypertension hemodynamics, risk assessment, prognosis, treatment response, and differentiation. Plasma ADM levels in pulmonary arterial hypertension patients at diagnosis were higher than in healthy controls ( p < 0.001), similar as in chronic thromboembolic pulmonary hypertension patients ( p = ns), but lower compared to HFpEF(PH) ( p < 0.03) and HFrEF(PH) ( p < 0.001). In pulmonary arterial hypertension, specifically, plasma ADM at diagnosis correlated mainly to mean right atrial pressure ( r = 0.73, p < 0.001), N-terminal prohormone of brain natriuretic peptide ( r = 0.75, p < 0.001), six-minute walking distance ( r = –0.57, p < 0.001), and venous oxygen saturation ( r = –0.57, p < 0.001). ADM also correlated to the ECS/ERS- ( r = 0.74, p < 0.001) and REVEAL risk scores ( r = 0.54, p < 0.001) at pulmonary arterial hypertension diagnosis. Plasma ADM in pulmonary arterial hypertension patients was unaltered at early treatment follow-up compared to baseline ( p = ns). Pulmonary arterial hypertension patients with supra-median ADM at diagnosis showed worse overall survival than those with infra-median levels (median survival 34 versus 66 months, p = 0.0077). In conclusion, the present results suggest that baseline plasma ADM levels mirror disease severity, correlating to both ECS/ERS- and the REVEAL risk scores.

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Section: Discussionmentioning

confidence: 99%

“…17,18 Notably, a previous study has shown that MR-proADM is correlated to exercise capacity and related to one-year mortality in PAH and chronic thromboembolic PH (CTEPH) patients. 19…”

Section: Introductionmentioning

confidence: 99%

Plasma adrenomedullin peptides and precursor levels in pulmonary arterial hypertension disease severity and risk stratification

Bouzina¹,

Rådegran²

2020

Pulm. circ.

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“…According to the study results, MR-proADM was found as a good predictor of short-and long-term allcause mortality in CAP patients. A recently published prospective multicenter study demonstrated that MR-proANP and MR-proADM were associated with exercise variables and prognosis in pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) (15). MR-proADM is a good prognostic indicator of mortality, and it may have a contributory effect in the risk stratification of acute dyspnea patients.…”

Section: Discussionmentioning

confidence: 99%

MR-proADM and MR-proANP levels in patients with acute pulmonary embolism

Öner

Deveci

Telo

et al. 2019

Journal of Medical Biochemistry

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Summary Background The aim of this study was to determine levels of Mid-regional Pro-adrenomedullin (MR-proADM) and Mid-regional Pro-atrial Natriuretic Peptide (MR-proANP) in patients with acute pulmonary embolism (PE), the relationship between these parameters and the risk classification in addition to determining the relationship between 1- and 3-month mortality. Methods 82 PE patients and 50 healthy control subjects were included in the study. Blood samples for MR-proANP and MR-proADM were obtained from the subjects prior to the treatment. Risk stratification was determined according to sPESI (Simplified Pulmonary Embolism Severity Index). Following these initial measurements, cases with PE were assessed in terms of all causative and PE related mortalities. Results The mean serum MR-proANP and MR-proADM levels in acute PE patients were found to be statistically higher compared to the control group (p < 0.001, p < 0.01; respectively) and statistically significantly higher in high-risk patients than low-risk patients (p < 0.01, p < 0.05; respectively). No statistical difference was determined in high-risk patients in case of sPESI compared to low-risk patients while hospital mortality rates were higher. It was determined that the hospital mortality rate in cases with MR-proANP ≥ 123.30 pmol/L and the total 3-month mortality rate in cases with MR-proADM ≥ 152.2 pg/mL showed a statistically significant increase. Conclusions This study showed that MR-proANP and MR-proADM may be an important biochemical marker for determining high-risk cases and predicting the mortality in PE patients and we believe that these results should be supported by further and extensive studies.

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“…Andreassen et al ( 25 ) confirmed that the elevated levels of NT-proBNP in PAH patients are associated with hemodynamics. Kolditz et al ( 26 ) suggested that different biomarkers respond to different aspects of the pathogenesis of PH and NT-proBNP was significantly correlated with hemodynamics. The present study indicated that milrinone significantly reduces NT-proBNP and hsCRP in patients with PH-LHD.…”

Section: Discussionmentioning

confidence: 99%

Study on the clinical efficacy of specific phosphodiesterase inhibitor in patients with pulmonary hypertension due to left heart disease

Han

Wang

2018

Exp Ther Med

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Pulmonary hypertension due to left heart disease (PH-LHD) is caused by left ventricular (LV) systolic and/or diastolic dysfunction and left heart valve disease. LV diseases lead to left ventricular filling pressure increases, pulmonary venous obstruction and pulmonary venous pressure increases, and thus to secondary PH. Exercise tolerance is lower and fatality rates are higher in patients with PH-LHD than those in subjects with normal pulmonary arterial pressure. In spite of the progress in the study of the mechanisms of PH-LHD in recent years, no specific treatment is currently available. The efficacy and safety of targeted therapies for pulmonary arterial hypertension remain to be fully established. In the present study, PH-LHD patients were treated with milrinone injection. It was concluded that milrinone significantly reduces pulmonary artery systolic pressure (PASP) in patients with PH-LHD, and significantly improves the cardiac structure, cardiac function and biochemical indexes. PASP was significantly correlated with the left atrial diameter, LV end diastolic diameter, LV ejection fraction, tricuspid annular plane systolic excursion, right ventricular fractional area change, N-terminal pro-B-type natriuretic peptide and hypersensitive C-reactive protein.

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MR-proADM Predicts Exercise Capacity and Survival Superior to Other Biomarkers in PH

Cited by 14 publications

References 50 publications

Plasma adrenomedullin peptides and precursor levels in pulmonary arterial hypertension disease severity and risk stratification

Plasma adrenomedullin peptides and precursor levels in pulmonary arterial hypertension disease severity and risk stratification

MR-proADM and MR-proANP levels in patients with acute pulmonary embolism

Study on the clinical efficacy of specific phosphodiesterase inhibitor in patients with pulmonary hypertension due to left heart disease

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