[Study on the clinical significance of plasma adrenomedullin and brain natriuretic polypeptide in the patients with chronic cor pulmonale on highland]

Abstract

Objective: To study the clinical significance of plasma adrenomedullin (ADM) and brain natriuretic polypeptide (BNP) in the patients with chronic cor pulmonale on highland (HACCP).

Methods: The levels of ADM and BNP in plasma of 44 patients with HACCP in the acute and in the remission stages were determined with radioimmunoassay. Their correlations with partial pressure of oxygen in arterial blood (PaO(2)), endothelin-1 (ET-1), and the ratio of right ventricular pre-ejection time to the pulmonary flow acceleration time (RVPEP/AT), which reflected the degree of pulmonary hypertension, were investigated. Twenty healthy subjects served as a normal control group.

Results: The levels of ADM [(38.8+/-7.2)ng/L and (26.2+/-5.3)ng/L] and BNP [(81.4+/-13.8)ng/L and (58.9+/-9.3)ng/L] in the acute and remission stages of cor pulmonale groups were both significantly higher than those in the normal control group [(15.0+/-3.2)ng/L, (38.6+/-3.4)ng/L, respectively, all P<0.01]. The levels of ADM and BNP in acute stage were both significantly higher than those in remission stage (both P<0.01). In the acute and in the remission stages, the levels of ADM in plasma were negatively correlated with PaO(2) (r(a)=-0.826, P<0.01; r(r)=-0.783, P<0.01), positively correlated with ET-1 (r(a)=0.755, P<0.01; r(r)=0.668, P<0.01) and RVPEP/AT ratio (r(a)=0.788, P<0.01; r(r)=0.734, P<0.01). In the acute and in the remission stages, the levels of BNP in plasma were negatively correlated with PaO(2) (r(a)=-0.787, P<0.01; r(r)=-0.554, P<0.01), positively correlated with ET-1 (r(a)=0.725, P<0.01; r(r)=0.679, P<0.01) and RVPEP/AT ratio (r(a)=0.771, P<0.01; r(r)=0.722, P<0.01).

Conclusion: The study suggests that ADM and BNP are involved in the pathophysiological process of HACCP in the patients and may play a compensatory role in the disease.