Changes of plasma adrenomedullin in children with congenital heart disease combined with heart failure and their clinical implication / 实用医学杂志

ABSTRACT

Objective To explore the changes of plasma level of adrenomedullin(ADM)in congenital heart disease patients with heart failure,analyze the relationship between ADM and the severity of heart failure, assess the value of plasma ADM in the diagnosis of CHF and evaluate the cardiac function in pediatric patients with congenital heart disease. Methods 46 patients with CHD were enrolled according to the modified Ross Score. They were divided into three groupsmild CHF group(n = 16)and moderate CHF group(n = 18)and severe CHF group(n = 12). 25 matched normal children were enrolled as controls. Plasma ADM was measured with radioimmunoassay(RIA)and the contents of NT-proBNP were determined among all the patients. LVEF and E/A in all of them were also detected. The relationship between plasma ADM level and modified Ross Score and echocardiographic cardiac functional indexes was analyzed. Results Plasma ADM was positively correlated with modified Ross Score(r = 0.65,P < 0.01). Plasma ADM concentration in the severe CHF group was significantly higher than that of mild and moderate CHF group(P < 0.01),and plasma ADM concentration in the mild CHF group was higher than that in the control group(P<0.05).Plasma ADM was negatively correlated with LVEF and E/A(r =-1.05,P < 0.01). Conclusion Plasma ADM level could be used to assess cardiac function and diag-nose CHF with CHD.