Heart failure & cardiomyopathies
Adrenomedullin Peptides and Precursor Levels in Relation to Haemodynamics and Prognosis After Heart Transplantation
Authors' conclusion
Elevated plasma levels of ADM may be a marker of pressure/volume overload in HF patients with PH, as well as long-term prognosis after HT. In line with previous studies, our findings additionally confirm that ADM may be a marker of venous congestion in HF.
Study context
- Population
- Patients with advanced heart failure (HF) and pulmonary hypertension (PH) undergoing heart transplantation (HT)
- Participants
- 67 vs 20
- Exposure
- HF patients with PH before vs 1 year after HT, and vs healthy controls
- HF with PHn = 67
- Healthy controlsn = 20reference
- Outcome
- Plasma CV proteins (NT-proBNP and 18 proteins, proximity extension assay)
- Follow-up
- Before and 1 year after HT
Methodological detailsPrognosis by Kaplan-Meier and Cox regression, Haemodynamics by right heart catheterization pre-operatively and at 1 year after HT
- Prognosis by Kaplan-Meier and Cox regression
- Haemodynamics by right heart catheterization pre-operatively and at 1 year after HT
Main finding
As reported in the abstract
Decrease in ADM correlated with decreased mean right atrial pressure
rs = 0.61
P = 0.0077
Decrease in ADM correlated with decreased N-terminal pro-brain natriuretic peptide (NT-proBNP)
rs = 0.75
P = 0.00025
Decrease in ADM correlated with decreased stroke volume index
rs = −0.52
P = 0.022
Observational data: associations, not effects.
Further findings
Survival by ADM level (Cox regression)
| HR (95% CI) | P value | ||
|---|---|---|---|
| ADM levelUnivariable | 1.007 (1.00–1.015) | P = 0.049 | |
| ADM levelAdjusted for NT-proBNP | 1.01 (1.00–1.021) | P = 0.041 | |
| 0.512Hazard ratio (log scale) |
| Outcome | P value |
|---|---|
| Prognosis by pre-operative ADM: event-free survival (HT or death) and survivalHigh ADM vs Low ADM · event-free survival (HT or death), worse with high ADM | log-rank P value = 0.023 |
| Prognosis by pre-operative ADM: event-free survival (HT or death) and survivalHigh ADM vs Low ADM · survival (log-rank), worse with high ADM | 0.0225 |
Original publication
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