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Title: The midregional portion of proadrenomedullin is an independent predictor of left ventricular mass index in hypertension
Authors: Bhandari, S. S.
Davies, J. E.
Struck, J.
Ng, L. L.
First Published: Jan-2010
Publisher: Elsevier
Citation: Metabolism. Volume 59, Issue 1, January 2010, Pages 7-13. The midregional portion of proadrenomedullin is an independent predictor of left ventricular mass index in hypertension. Sanjay S. Bhandaria, Joan E. Daviesa, Joachim Struckb and Leong L. Nga.
Abstract: Left ventricular hypertrophy (LVH) is a risk factor for cardiovascular disease. Elevated natriuretic peptides in LVH have spurred interest that biomarkers may play a role in screening programs. Adrenomedullin (ADM) is a 52-amino acid peptide mediating vasorelaxation, natriuresis, and diuresis. The midregional portion of proADM (MRproADM) is secreted stoichiometrically with ADM; hence, it can be used as a surrogate marker of ADM. We compared the diagnostic performance of MRproADM for the detection of LVH with N-terminal pro-Btype natriuretic peptide (NTproBNP). Two hundred fifty-three hypertensive patients were derived from a local screening study. The MRproADM and NTproBNP levels were assayed using immunoluminometric assays. The MRproADM levels were significantly elevated in patients with LVH than those without (mean [SD]: 0.73 [0.25] vs 0.59 [0.18] nmol/L, P b .001). In multivariate analyses, male sex (P b .001) and log MRproADM (P = .003) retained significance for detecting LVH. Receiver operating characteristic curve for MRproADM yielded an area under the curve of 0.71; confidence interval, 0.62-0.81; P b .001, superior to NTproBNP. An optimal cutoff value for RproADM as an indicator of LVH was 0.50 nmol/L, with a sensitivity, specificity, and negative redictive value of 90.5%, 36.5%, and 95.1%, respectively. The high negative predictive value of the MRproADM assay allows it to be used as a rule-out test for LVH when stratifying patients into high or low risk. Patients who test positive would necessitate echocardiography, enabling better resource allocation.
DOI Link: 10.1016/j.metabol.2009.06.019
ISSN: 0026-0495
Type: Article
Description: Metadata. Full text of this item is not currently available on the LRA.
Appears in Collections:Published Articles, Dept. of Cardiovascular Sciences

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