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Exercise-Induced Increase in Circulating Adrenomedullin Is Related to Mean Blood Pressure in Heart Transplant Recipients

Laboratoire des Régulations Physiologiques et des Rythmes Biologiques chez l’Homme et Service de Chirurgie Cardio-Vasculaire, Faculté de Médecine, 67085 Strasbourg, France

Address correspondence and requests for reprints to: Dr. François Piquard, Institut de Physiologie, Faculté de Médecine, 67085 Strasbourg Cedex, France. E-mail: Francois.Piquard{at}physio-ulp.u-strasbg.fr

Adrenomedullin (ADM) is a newly discovered potent vasorelaxing and natriuretic peptide that recently has been shown to be increased after heart transplantation. To investigate the hemodynamic factors modulating its release and the eventual role of ADM in blood pressure regulation after heart transplantation, seven matched heart-transplant recipients (Htx) and seven normal subjects performed a maximal bicycle exercise test while monitoring for heart rate, blood pressure, and circulating ADM. Baseline heart rate and systemic blood pressure were higher in Htx; left ventricular mass index and ADM tended to be higher after heart transplantation and correlated positively in Htx (r = 0.79, P = 0.03). As expected, exercise-induced increase in heart rate was lower in Htx than in controls (60 ± 11 % vs. 121 ± 14 %, respectively) and blood pressure increase was similar in both groups. Maximal exercise increased significantly plasma ADM in both groups (from 25.3 ± 3.1 to 30.7 ± 3.5 pmol/L, P < 0.05 and from 15.2 ± 1.4 to 29.1 ± 4.4 pmol/L, P = 0.02 in Htx and controls, respectively), the hypotensive peptide level remaining elevated until the 30th min of recovery. A significant inverse relationship was observed between peak mean blood pressure and circulating ADM in Htx (r = -0.86, P < 0.02). Besides showing that circulating ADM is increased after heart transplantation, the present study demonstrates a positive relationship between baseline ADM and left ventricular mass index. Furthermore, maximal exercise-induced increase in ADM is inversely related to mean blood pressure in Htx, suggesting that ADM might participate in blood pressure regulation during exercise after heart transplantation.

This article has been cited by other articles:

				R. Richard, J. Zoll, B. Mettauer, F. Piquard, and B. Geny Counterpoint: Cardiac denervation does not play a major role in exercise limitation after heart transplantation J Appl Physiol, February 1, 2008; 104(2): 560 - 562. [Full Text] [PDF]

				B. Geny, R. Richard, B. Mettauer, J. Lonsdorfer, and F. Piquard Cardiac natriuretic peptides during exercise and training after heart transplantation Cardiovasc Res, August 15, 2001; 51(3): 521 - 528. [Full Text] [PDF]