Relationship of the plasma urotensin || with proadrenomedullin N-terminal 20 peptide in patients with congestive heart failure

摘要

Objective: To understand the role of urotensin Ⅱ ( U Ⅱ) and proadrenomedullin N-terminal 20 peptide (PAMP), a fragment of proadrenomedullin (proADM) possessing biological activity, in the pathophysiological process of congestive heart failure (CHF) by observing the variation of their plasma levels and exploring their interrelations. Methods: Plasma U Ⅱ and PAMP levels were measured by radioimmunoassay in 52 patients with CHF and 14 healthy subjects. Left ventricular ejection fraction (LVEF) and the ratio of E/A were determined by echocardiography. Results : The plasma U Ⅱ level was significantly lower in patients with CHF than the healthy subjects (1.5 +- 1.0 pg/ml vs 4. 3 +- 1.2 pg/ml, P<0.05), while plasma PAMP level was significantly higher in the former group (30.6 +- 5.8 pg/ml vs 21.0 +- 6. 6 pg/ml P < 0. 05). The levels of U Ⅱ and PAMP were parallel with the severity of CHF, and significant correlation of plasma levels of U Ⅱ with LVEF (r = 0.530, P = 0.000) and the ratio of E/A (r = 0.618, P = 0.000) was noted. LVEF and ratio of E/A were found to be inversely correlated with plasma PAMP levels in the patients ( r = ―0. 568 , P = 0. 000; r = ―0. 350, P = 0. 004) . Also found was the significant correlation between plasma U II and PAMP levels (r = ―0. 528 , P = 0. 000 ) . The treatment of the patients resulted in increased plasma U Ⅱ levels and lowered PAMP levels. Conclusion: The variations of plasma levels of U Ⅱ and PAMP are parallel with the severity of CHF, suggesting their cooperative actions in the pathophysiology of CHF.