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Plasma mid-regional proadrenomedullin level in children with pulmonary hypertension associated with CHD

Published online by Cambridge University Press:  04 April 2023

Shimaa A. Elesawy ,
Hesham A. El-Serogy ,
Esraa A. Sorour Open the ORCID record for Esraa A. Sorour [Opens in a new window]  and
Amr M. Zoair
Shimaa A. Elesawy
Affiliation:
Dar Elsalam General Hospital, Ministry of Health, Cairo, Egypt
Hesham A. El-Serogy
Affiliation:
Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Esraa A. Sorour*
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Amr M. Zoair
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
*
Author for correspondence: Esraa A. Sorour, Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt. E-mail: esraa.fotouh@med.tanta.edu.eg
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Abstract

Adrenomedullin has been shown to inhibit proliferation in pulmonary artery smooth muscle cells and to alleviate pulmonary artery collagen accumulation in pulmonary hypertension. We aimed to assess mid-regional proadrenomedullin level in children with pulmonary hypertension due to CHDs. The current study was conducted in the Pediatric Cardiology Unit, Tanta University Hospital, on 50 children with CHDs: twenty-five patients had a complication of pulmonary hypertension and the other 25 patients without pulmonary hypertension. Another 25 children without CHDs were concluded as a control group. We performed complete history taking, full clinical assessment, chest X-ray, electrocardiogram, and echocardiographic assessment. Plasma level of mid-regional proadrenomedullin was assessed using a sandwich enzyme-linked immunosorbent assay test. Our results showed that the mean plasma level of mid-regional proadrenomedullin was significantly increased in patients with pulmonary hypertension. Significant positive correlation was found between mid-regional proadrenomedullin and mean pulmonary artery pressure. The best cut-off point of mid-regional proadrenomedullin as a diagnostic biomarker to discriminate patients with CHDs complicated with pulmonary hypertension was 199.22 nmol/l. Mid-regional proadrenomedullin significantly increased in patients with pulmonary hypertension who died as compared to patients who survived, with the best cut-off point was 428,8 nmol/l. We concluded that plasma levels of mid-regional proadrenomedullin were significantly elevated in children with pulmonary hypertension complicated by the CHDs. It could be used as a cardiac biomarker in these patients, with good diagnostic and prognostic value.

Keywords

pulmonary hypertensionmid-regional proadrenomedullinCHDs
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 12 , December 2023 , pp. 2567 - 2573
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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References

Simonneau, G, Gatzoulis, MA, Adatia, I, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013; 62: 34–41.CrossRefGoogle ScholarPubMed
Galie, N, Humbert, M, Vachiery, JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: association for European Pediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 2016; 37: 67–119.CrossRefGoogle Scholar
Kitamura, K, Kangawa, K, Kawamoto, M, et al. Adrenomedullin: a novel hypotensive peptide isolated from human pheochromocytoma. Biochem Biophys Res Commun 1993; 192: 553–560.CrossRefGoogle ScholarPubMed
Ichiki, Y, Kitamura, K, Kangawa, K, et al. Distribution and characterization of immunoreactive adrenomedullin in human tissue and plasma. FEBS Lett 1994; 338: 6–10.CrossRefGoogle ScholarPubMed
Sakata, J, Shimokubo, T, Kitamura, K, et al. Distribution and characterization of immunoreactive rat adrenomedullin in tissue and plasma. FEBS Lett 1994; 352: 105–108.CrossRefGoogle ScholarPubMed
Owji, AA, Smith, DM, Coppock, HA, et al. An abundant and specific binding site for the novel vasodilator adrenomedullin in the rat. Endocrinology 1995; 136: 2127–2134.CrossRefGoogle ScholarPubMed
Kakishita, M, Nishikimi, T, Okano, Y, et al. Increased plasma levels of adrenomedullin in patients with pulmonary hypertension. Clin Sci 1999; 96: 33–39.CrossRefGoogle ScholarPubMed
Wong, HK, Cheung, TT, Cheung, BM. Adrenomedullin and cardiovascular diseases. JRSM Cardiovasc Dis 2012; 1: 1–7.CrossRefGoogle ScholarPubMed
Upton, PD, Wharton, J, Coppock, H, et al. Adrenomedullin expression and growth inhibitory effects in distinct pulmonary artery smooth muscle cell subpopulations. Am J Respir Cell Mol Biol 2001; 24: 170–178.CrossRefGoogle ScholarPubMed
Li, W, Kong, QY, Zhao, CF, et al. Adrenomedullin and adrenotensin regulate collagen synthesis and proliferation in pulmonary arterial smooth muscle cells. Braz J Med Biol Res 2013; 46: 1047–1055.CrossRefGoogle ScholarPubMed
Pang, L, Qi, J, Gao, Y, et al. Adrenomedullin alleviates pulmonary artery collagen accumulation in rats with pulmonary hypertension induced by high blood flow. Peptides 2014; 54: 101–107.CrossRefGoogle ScholarPubMed
Morgenthaler, NG, Struck, J, Alonso, C, et al. Measurement of midregional proadrenomedullin in plasma with an immunoluminometric assay. Clin Chem 2005; 51: 1823–1829.CrossRefGoogle ScholarPubMed
Morgenthaler, NG, Struck, J, Thomas, B, et al. Immunoluminometric assay for the midregion of pro-atrial natriuretic peptide in human plasma. Clin Chem 2004; 50: 234–236.CrossRefGoogle ScholarPubMed
Caruhel, P, Mazier, C, Kunde, J, et al. Homogeneous time-resolved fluoroimmunoassay for the measurement of midregional proadrenomedullin in plasma on the fully automated system BRAHMS KRYPTOR®. Clin Biochem 2009; 42: 725–728.CrossRefGoogle Scholar
Struck, J, Tao, C, Morgenthaler, NG, et al. Identification of an adrenomedullin precursor fragment in plasma of sepsis patients. Peptides 2004; 25: 1369–1372.CrossRefGoogle ScholarPubMed
Simonneau, G, Galiè, N, Rubin, LJ, et al. Clinical classification of pulmonary hypertension. J Am Coll Cardiol 2004; 43 (12Suppl): 5S–12S.CrossRefGoogle ScholarPubMed
Yoshibayashi, M, Kamiya, T, Kitamura, K, et al. Plasma levels of adrenomedullin in primary and secondary pulmonary hypertension in patients < 20 years of age. Am J Cardiol 1997; 79: 1556–1558.CrossRefGoogle ScholarPubMed
Potocki, M, Ziller, R, Mueller, C. Mid-regional pro-adrenomedullin in acute heart failure: a better biomarker or just another biomarker. Curr Heart Fail Rep 2012: 244–251.CrossRefGoogle ScholarPubMed
Li, G, Li, Y, Tan, X, et al. Plasma growth differentiation factor-15 is a potential biomarker for pediatric pulmonary arterial hypertension associated with congenital heart disease. Pediatr Cardiol 2017; 38: 1620–1626.CrossRefGoogle ScholarPubMed
Azakie, A, Johnson, NC, Anagnostopoulos, PV, et al. Cardiac surgery in low birth weight infants: current outcomes. Interact Cardiovasc Thorac Surg 2011; 12: 409–414.CrossRefGoogle ScholarPubMed
Elnoamany, MF, Ahmed, NF, Ragab, EM. Echocardiographic assessment of right ventricular function in patients with pulmonary hypertension: Strain imaging study. Menoufia Med J 2014; 27: 336–341.Google Scholar
Bréchot, N, Gambotti, L, Lafitte, S, et al. Usefulness of right ventricular isovolumic relaxation time in predicting systolic pulmonary artery pressure. Eur J Echocardiogr 2008; 9: 547–554.CrossRefGoogle ScholarPubMed
Vorhies, EE, Gajarski, RJ, Yu, S, et al. Echocardiographic evaluation of ventricular function in children with pulmonary hypertension. Pediatr Cardiol 2014; 35: 759–766.CrossRefGoogle ScholarPubMed
Bouzina, H, Radegran, G. Plasma adrenomedullin peptides and precursor levels in pulmonary arterial hypertension disease severity and risk stratification. Pulm Circ 2020; 10: 1–9.CrossRefGoogle ScholarPubMed
Zamzam, SM, Shedeed, SA, Mohammed, AM, et al. Mid regional proadrenomedullin as a diagnostic marker in pediatric heart failure. Egypt J Hosp Med 2022; 87: 1276–1280.CrossRefGoogle Scholar
Salem, S, Saleh, N, Soliman, S, et al. On admission plasma levels of BNP, MR-proADM, and cTnI in pediatric heart failure: contributions to diagnosis, prognosis, and outcome. Ir J Med Sci 2021; 71: 1–8.Google Scholar
Khan, S, O’Brien, R, Struck, J, et al. Prognostic value of midregional pro-adrenomedullin in patients with acute myocardial infarction: the LAMP (Leicester Acute Myocardial Infarction Peptide) study. J Am Coll Cardiol 2007; 49: 1525–1532.CrossRefGoogle ScholarPubMed
Gegenhuber, A, Struck, J, Dieplinger, B, et al. Comparative evaluation of b-type natriuretic peptide, mid-regional pro a-type natriuretic peptide, mid-regional pro-adrenomedullin, and copeptin to predict 1-year mortality in patients with acute destabilized heart failure. J Card Fail 2007; 13: 42–49.CrossRefGoogle ScholarPubMed
Benza, RL, Gomberg-Maitland, M, Miller, DP, et al. The REVEAL Registry risk score calculator in patients newly diagnosed with pulmonary arterial hypertension. Chest 2012; 141: 354–362.CrossRefGoogle ScholarPubMed