Biologically Active Adrenomedullin (bio-ADM) is of Potential Value in Identifying Congestion and Selecting Patients for Neurohormonal Blockade in Acute Dyspnea.
| Title: | Biologically Active Adrenomedullin (bio-ADM) is of Potential Value in Identifying Congestion and Selecting Patients for Neurohormonal Blockade in Acute Dyspnea. |
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| Authors: | Simonavičius J; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; Maastricht University Medical Centre, Maastricht, the Netherlands. Electronic address: j.simonavicius@gmail.com.; Mikalauskas A; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Čerlinskaitė K; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Gayat E; Inserm UMR-S 942, Cardiovascular Markers in Stress Conditions (MASCOT), Paris, France; Department of Anesthesiology and Critical Care, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique des Hopitaux de Paris, France; Université de Paris, France.; Juknevičius V; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine.; Palevičiūtė E; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine.; Alitoit-Marrote I; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Kablučko D; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Bagdonaitė L; Institute of Biomedical Science, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Balčiūnas M; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine.; Vaičiulienė D; Lithuanian University of Health Sciences, Kaunas, Lithuania.; Jonauskienė I; Lithuanian University of Health Sciences, Kaunas, Lithuania.; Motiejūnaitė J; Lithuanian University of Health Sciences, Kaunas, Lithuania.; Stašaitis K; Lithuanian University of Health Sciences, Kaunas, Lithuania.; Kukulskis A; Lithuanian University of Health Sciences, Kaunas, Lithuania.; Damalakas Š; Lithuanian University of Health Sciences, Kaunas, Lithuania.; Šimbelytė T; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Taparauskaitė N; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Pukanasienė G; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.; Laucevičius A; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine.; Kavoliūnienė A; Lithuanian University of Health Sciences, Kaunas, Lithuania.; Mebazaa A; Inserm UMR-S 942, Cardiovascular Markers in Stress Conditions (MASCOT), Paris, France; Department of Anesthesiology and Critical Care, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique des Hopitaux de Paris, France; Université de Paris, France.; Čelutkienė J; Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine. |
| Corporate Authors: | GREAT network |
| Source: | The American journal of medicine [Am J Med] 2022 Jul; Vol. 135 (7), pp. e165-e181. Date of Electronic Publication: 2022 Mar 02. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0267200 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1555-7162 (Electronic) Linking ISSN: 00029343 NLM ISO Abbreviation: Am J Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: New York, NY : Excerpta Medica; Original Publication: New York, Donnelly. |
| MeSH Terms: | Adrenomedullin* ; Respiratory Sounds*; Dyspnea/etiology ; Biomarkers ; Humans ; Patient Selection |
| Abstract: | Purpose: This study was designed to evaluate the role of biologically active adrenomedullin (bio-ADM) in congestion assessment and risk stratification in acute dyspnea.; Methods: This is a sub-analysis of the Lithuanian Echocardiography Study of Dyspnea in Acute Settings. Congestion was assessed by means of clinical (peripheral edema, rales) and sonographic (estimated right atrial pressure) parameters. Ninety-day mortality was chosen for outcome analysis.; Results: There were 1188 patients included. Bio-ADM concentration was higher in patients with peripheral edema at admission (48.2 [28.2-92.6] vs 35.4 [20.9-59.2] ng/L, P < .001). There was a stepwise increase in bio-ADM concentration with increasing prevalence of rales: 29.8 [18.8-51.1], 38.5 [27.5-67.1], and 51.1 [33.1-103.2] ng/L in patients with no rales, rales covering less than one-half, and greater than or equal to one-half of the pulmonary area, respectively (P < 0.001). Bio-ADM concentration demonstrated gradual elevation in patients with normal, moderately, and severely increased estimated right atrial pressure: 25.1 [17.6-42.4] ng/L, 36.1 [23.1-50.2], and 47.1 [30.7-86.7] ng/L, respectively (P < .05). Patients with bio-ADM concentration >35.5 ng/L were at more than twofold increased risk of dying (P < .001). Survival in those with high bio-ADM was significantly modified by neurohormonal blockade at admission (P < .05), especially if NT-proBNP levels were lower than the median (P = .002 for interaction).; Conclusion: Bio-ADM reflects the presence and the degree of pulmonary, peripheral, and intravascular volume overload and is strongly related to 90-day mortality in acute dyspnea. Patients with high bio-ADM levels demonstrated survival benefit from neurohormonal blockade.; (Copyright © 2022 Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: Adrenomedullin; Bio-ADM; Congestion; Dyspnea; Mortality; Neurohormonal blockade |
| Substance Nomenclature: | 0 (Biomarkers); 148498-78-6 (Adrenomedullin) |
| Entry Date(s): | Date Created: 20220304 Date Completed: 20220621 Latest Revision: 20220706 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.amjmed.2022.02.006 |
| PMID: | 35245495 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't