Relationships between plasma adrenomedullin concentration and systolic time intervals during static handgrip in patients with heart failure

Krzemiński, K; Cybulski, Gerard; Nazar, K

doi:10.1111/j.1475-097x.2008.00842.x

Cited by 7 publications

(9 citation statements)

References 55 publications

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“…Our findings also confirm the observations of Krzeminski et al (2009) that during increased inotropic states, variations in systolic time intervals uncorrected for heart rate reflect systolic changes well. That is, in situations of increased inotropy, such as during epinephrine infusion, systolic time intervals corrected for heart rate may mask the associated inotropic effect (Krzeminski et al 2009). …”

Section: Discussionsupporting

confidence: 92%

“…For detailed analysis of systolic time intervals see (Carliner et al 1974). Finally, in situations of increased inotropy, such as during epinephrine infusion, systolic time intervals corrected for heart rate may mask the associated inotropic effect (see Krzeminski et al 2009). To confirm this observation, therefore, we present both the absolute systolic time intervals (LVET, PEP) and heart rate changes based indices (LVETi, PEPi).…”

Section: Methodsmentioning

confidence: 99%

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Modulation of plasma adrenomedullin by epinephrine infusion during head up tilt

et al. 2010

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We investigated whether head up tilt (HUT) with and without simultaneous epinephrine infusion modulate plasma adrenomedullin. We studied eight healthy male volunteers, using two 5 min 70° HUT trials: control (saline infusion) and intervention (epinephrine infusion, titrated to a dose which increased supine systolic pressure by 20% above resting values). Protocols were randomized and separated by 2 weeks. Cardiac function and systolic time intervals, recorded using a phonocardiograph microphone, included left ventricular ejection time (LVET), pre-ejection period (PEP), PEP/LVET and electromechanical systole (QS2). Compared to saline infusion, epinephrine increased supine adrenomedullin (3.2 ± 0.8 pmol/l, i.e., mean ± SEM, respectively), heart rate (HR) (+11.3 ± 2.6 bpm), systolic pressure (+18.4 ± 2.6 mmHg) but decreased supine LVET, LVET corrected for HR (LVETi) and QS2-time (all p = 0.004). Despite similar HUT induced thoracic fluid shifts, reflected by similar thoracic impedance changes, HUT-induced adrenomedullin increases were minimal in epinephrine-supplemented men in comparison to controls (+8% vs. 42%). During HUT, epinephrine infusion decreased only the LVET (p = 0.039). Our findings confirm that short-term HUT increases plasma adrenomedullin. They further suggest that with increased supine epinephrine levels (epinephrine infusion clamping systolic arterial pressure at 120% control level), supine cardiac performance rises to a level similar to that during HUT, while adrenomedullin is still elevated with HUT. This might be in accordance with a 'dampening' role of adrenomedullin during catecholaminergic cardiovascular stimulation. As epinephrine is used as a drug to treat cardiac arrest and ventricular arrhythmias, our results may have important clinical/emergency resuscitation applications.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Modulation of plasma adrenomedullin by epinephrine infusion during head up tilt

et al. 2010

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“…Inverse relationships between static handgrip-induced changes in plasma ADM and those in PEP, PEP/LVET ratio, peak velocity and mean acceleration of the blood flow in the ascending aorta, and mean velocity of circumferential fiber shortening might be at least partly associated with inotropic action of ADM on the heart (Krzeminski et al, 2009, 2012; Krzeminski and Pawlowska-Jenerowicz, 2012). It should be noted that the PEP/LVET ratio has been proposed as a sensitive inverse index of left ventricular myocardial performance (Lewis et al, 1977; Martin et al, 1971; Weissler et al, 1969, 1972, 1980).…”

Section: Adrenomedullin and Static Exercisementioning

confidence: 99%

The Role of Adrenomedullin in Cardiovascular Response to Exercise – A Review

Krzemiński

2016

Journal of Human Kinetics

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Adrenomedullin (ADM), the product of the vascular endothelial and smooth muscle cells, and cardiomyocytes, is considered to be a local factor controlling vascular tone, cardiac contractility and renal sodium excretion. The aim of this article was to review the existing data on the effect of different types of exercise on plasma ADM concentration in healthy men. The results of studies on the effect of dynamic exercise on the plasma ADM are contradictory. Some authors reported an increase in plasma ADM, while others showed a slight decrease or did not observe any changes. The inverse relationship between plasma ADM and mean blood pressure observed during maximal exercise support the concept that ADM might blunt the exercise-induced systemic blood pressure increase. Positive relationships between increases in plasma ADM and those in noradrenaline, atrial natriuretic peptide (ANP) or interleukin-6 observed during prolonged exercise suggest that the sympathetic nervous system and cytokine induction may be involved in ADM release. Increased secretion of ADM and ANP during this type of exercise may be a compensatory mechanism attenuating elevation of blood pressure and preventing deterioration of cardiac function. Studies performed during static exercise have showed an increase in plasma ADM only in older healthy men. Positive correlations between increases in plasma ADM and those in noradrenaline and endothelin-1 may indicate the interaction of these hormones in shaping the cardiovascular response to static exercise. Inverse relationships between exercise-induced changes in plasma ADM and those in cardiovascular indices may be at least partly associated with inotropic action of ADM on the heart. Interactions of ADM with vasoactive peptides, catecholamines and hemodynamic factors demonstrate the potential involvement of this peptide in the regulation of blood pressure and myocardial contractility during exercise.

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“…On the other hand, we have recently demonstrated that static handgrip caused also an increase in the plasma adrenomedullin (ADM), which is a potent vasorelaxant probably involved in the fine blood pressure control counteracting the effect of vasoconstrictors. The increase in plasma ADM level was found in older healthy subjects and patients with heart failure (Krzeminski et al 2002, 2006, 2009). …”

Section: Introductionmentioning

confidence: 98%

“…Since our previous study performed in older healthy men and in patients with heart failure (Krzeminski et al 2002, 2006, 2009) showed interrelationships between changes in plasma ADM, catecholamine and cardiovascular responses to handgrip, it seemed of interest to extend these data to healthy young persons. Our hypothesis is that in healthy older subjects, the contribution of vasoactive hormones to cardiovascular response to static handgrip is greater than in young men.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular and hormonal responses to static handgrip in young and older healthy men

et al. 2011

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The purpose of this study was to investigate the effect of age on cardiovascular changes and plasma concentrations of adrenomedullin (ADM), catecholamines, endothelin-1 (ET-1) and plasma renin activity (PRA) in healthy men. A total of 15 young (21 ± 0.3 years) and 15 older (64 ± 0.7 years) healthy men performed two 3-min bouts of static handgrip at 30% of maximal voluntary contraction, alternately with each hand without any break between the bouts. During exercise heart rate (HR), blood pressure (BP), stroke volume (SV) and pre-ejection period (PEP) and left ventricle ejection time (LVET) were measured. Blood samples were taken before exercise, at the end of both exercise bouts and in the fifth minute of the recovery period. The handgrip-induced increases in HR and cardiac output were significantly smaller in older than in young men (p < 0.01). SV decreased only in older men (p < 0.001). There were no differences between groups in BP increases. The baseline plasma ADM and catecholamines were higher in older man compared to young subjects. Handgrip caused increases in plasma ADM, ET-1 and PRA only in older men (p < 0.05). The increases in plasma ADM correlated positively with those of noradrenaline (NA), PRA, ET-1 and LVET and negatively with changes in total peripheral resistance (TPR), SV, PEP and PEP/LVET ratio. The increases in plasma ET-1 correlated positively with those of NA, PRA, TPR, mean BP and SV. These results revealed that ADM, ET-1 and angiotensin II can contribute to maintain vascular tone during static exercise in older but not in younger men.

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Relationships between plasma adrenomedullin concentration and systolic time intervals during static handgrip in patients with heart failure

Cited by 7 publications

References 55 publications

Modulation of plasma adrenomedullin by epinephrine infusion during head up tilt

Modulation of plasma adrenomedullin by epinephrine infusion during head up tilt

The Role of Adrenomedullin in Cardiovascular Response to Exercise – A Review

Cardiovascular and hormonal responses to static handgrip in young and older healthy men

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