ABSTRACT
Localization of adrenomedullin [ADM] in peripheral tissues, including the heart, kidney, and vasculature, suggests an important role for the peptide as a regulator of cardiovascular function. ADM has hemodynamic effects including vasodilation, increases in cardiac contractility cardiac output, diuresis, and natriuresis. These effects may incorporate many of the therapeutic goals of heart failure management. The aim of our study was to find a relation between plasma level of ADM and Nitric Oxide [NO] in heat failure, with special interests to the type of heart disease, age, sex of patients, and severity of heart failure. We compared plasma levels of ADM and Nitric oxide [NO] in three groups of patients with heart failure: 14 patients diagnosed as rheumatic heart disease [RHD] [group I], 10 patients diagnosed as congenital heart disease [CHD] [group II], 6 patients diagnosed as dilated cardiomyopathy [DCM] [group III] and 20 apparently healthy children who were taken as controls [group IV]. Patients with heart failure had significantly higher levels of ADM and NO than controls [p=0.0001]. ADM and NO were highest among the patients with heart failure due to RHD then congenital heart disease and lastly dilated cardiomyopathy respectively [P=0.02 and 0.04 respectively]. We concluded that ADM is a biochemical marker for evaluating the severity of heart failure, and may be a new and promising approach for the treatment of patients with heart failure and pulmonary hypertension in children. In the future, insights into the role of NO in cardiac remodeling should allow the development of novel therapeutic strategies to treat cardiac remodeling and failure in infants and children