Effects of Long-Term Intravenous Administration of Adrenomedullin (AM) Plus hANP Therapy in Acute Decompensated Heart Failure -A Pilot Study-

摘要

Background: It was reported previously that 30 min administration of adrenomedullin (AM) improves hemo-dynamics in chronic stable heart failure patients. The present study was designed to examine whether long-term AM+human atrial natriuretic peptide (hANP) administration can be used as a therapeutic drug in patients with acute decompensated heart failure (ADHF) in clinical setting.Methods and Results: Seven acute heart failure patients (74+5 years) with dyspnea and pulmonary congestion were studied. AM (0.02mug-kg~(-1)-min~(-1))+hANP (0.05mug-kg~(-1)-mn~(-1)) was infused for 12h and then hANP (0.05mug; kg~(-1)min~(-1)) was infused for 12h. Hemodynamic, renal, hormonal and oxidative stress responses were evaluated. AM+hANP significantly reduced mean arterial pressure, pulmonary arterial pressure and systemic and pulmonary vascular resistance without changing heart rate, and increased cardiac output for most time-points compared with those at baseline. In addition, AM+hANP reduced aldosterone, brain natriuretic peptide and free-radical metabolites compared with those at baseline (all P<0.05). AM+hANP increased urine volume and U_NaV compared with baseline data.Conclusions: In this small, pilot trial, AM+hANP therapy had beneficial hemodynamic and hormonal effects in ADHF. Intravenous infusion of AM with hANP could be used as a therapeutic drug in ADHF. These data are preliminary and require confirmation in a larger clinical study.