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

Abstract

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.

Impact of cardiac rehabilitation and exercise training programs in coronary heart disease

“…80 These molecules attenuate BP by suppressing noradrenaline and endothelin-1, and improving endothelial responsiveness and function. 81,82 ET also protects against oxidative stress, leading to lower nitric oxide scavenging by oxidation and higher nitric oxide bioavailability which have anti-hypertensive effects. 83 ET-induced improvements in managing oxidative stress help lower systemic inflammatory markers in physically active people with CHD.…”

Effects of MERTK Inhibitors UNC569 and UNC1062 on the Growth of Acute Myeloid Leukaemia Cells

“…Therefore, this effect of UNC569 may be an advantage of an anti-leukaemia drug. However, because ADM is also involved in vasodilation (11), administration of UNC569 might result in changes in blood pressure.…”

Cardiac rehabilitation

“…The other mechanism for regulation of sympathetic tone is via adrenomodullin and atrio/brain-natriureticpeptides which are related closely to aerobic consumption. As a result BP reduction by suppressing noradrenaline and endothelin-1, and improving endothelial responsiveness and function [50][51][52]. ET also protects against oxidative stress and leads to increase in nitric oxide levels which have anti-hypertensive effects [53].…”