Published Online
on July 19, 2004

A more recent version of this article appeared on July 27, 2004

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Submitted on November 18, 2003
Revised on March 23, 2004
Accepted on March 26, 2004

Adrenomedullin Administration Immediately After Myocardial Infarction Ameliorates Progression of Heart Failure in Rats

Ryosai Nakamura MD, Johji Kato MD, PhD, Kazuo Kitamura MD, PhD, Hisamitsu Onitsuka MD, PhD, Takuroh Imamura MD, PhD, Yuanning Cao MD, Kousuke Marutsuka MD, PhD, Yujiro Asada MD, PhD, Kenji Kangawa PhD, and Tanenao Eto MD, PhD^*

From the First Department of Internal Medicine (R.N., J.K., K. Kitamura, H.O., T.I., Y.C., T.E.) and First Department of Pathology (K.M., Y.A.), Miyazaki Medical College, University of Miyazaki, Miyazaki, and Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka (K. Kangawa), Japan.

^* To whom correspondence should be addressed. E-mail: keto{at}med.miyazaki-u.ac.jp.

Background--Adrenomedullin (AM) is expressed in cardiac tissue, and plasma AM levels increase in patients with acute myocardial infarction (MI). This study was performed to determine whether AM administration immediately after acute MI inhibits progression of heart failure in rats.

Methods and Results--Rats were infused with 1.0 µg/h IP AM or saline over 7 days immediately after MI inducted by left coronary ligation and were examined 9 weeks after MI. Compared with the saline infusion, AM infusion significantly improved survival (59% versus 81%; P<0.05) and body weight gain (32%; P<0.01) and reduced heart weight (-28%; P<0.01), lung weight (-26%; P<0.01), left ventricular (LV) end-diastolic pressure (11.4±2.0 versus 4.0±0.6 mm Hg, mean± SEM; P<0.01), collagen volume fraction of noninfarcted LV (-39%; P<0.05), and plasma levels of endogenous rat AM (-38%; P<0.05) without affecting infarct size. To investigate the mechanism of AM actions, another series of MI rats infused with AM were killed on day 7. AM infusion had no effect on organ weights and hemodynamic parameters on day 7 of MI but significantly reduced urinary excretion of isoprostane (-61%; P<0.01) and noninfarcted LV mRNA levels of ACE (-31%; P<0.05) and p22-phox (-30%; P<0.05).

Conclusions--AM administration during the early period of MI improved the survival and ameliorated progression of LV remodeling and heart failure. This beneficial effect was accompanied by reductions in oxidative stress and ACE mRNA expression in noninfarcted LV in the AM infusion period.

Key words: adrenomedullin • heart failure • myocardial infarction • remodeling

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