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Adrenomedullin as a Biomarker of Heart Failure
Toshio Nishikimi1, Yasuaki Nakagawa2
1Department of Cardiovascular Medicine, Graduate School of Medicine Kyoto University, 54, Shogoin-Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Department of Medicine, Wakakusa-Tatsuma Rehabilitation Hospital, 1580 Tatsuma, Daito City, Osaka 574-0012, Japan.
Abstract:
Adrenomedullin (AM) is a vasodilatory peptide originally discovered in human pheochromocytoma tissue. Although AM is highly expressed in the adrenal glands, heart, lungs, and kidneys, vascular endothelium and smooth muscle are thought to be the main source of plasma AM. The AM precursor is processed to AM-glycine, which is then converted to AM-mature through C-terminal amidation. In this process, mid-regional pro-adrenomedullin (MR-proAM) is also produced. Plasma AM, AM-mature, AM-glycine, and MR-proAM levels are all higher in patients with heart failure than healthy subjects in proportional to the disease severity. All molecular forms of AM are prognostic markers for heart failure.
