Adrenomedullin and cardiovascular diseases.
Adrenomedullin and cardiovascular diseases.
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DOI：
10.1258/cvd.2012.012003
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发表时间：
2012-08-10
影响因子：
1.6
通讯作者：
Cheung BM
中科院分区：
文献类型：
--
作者：
Wong HK;Cheung TT;Cheung BM
心血管系统受自主神经系统、肾素-血管紧张素-醛固酮系统、一氧化氮（NO）和包括神经肽在内的其它因素的调节。对神经体液因子的研究导致了许多心血管药物的开发。肾上腺髓质素（ADM）最初从肾上腺中分离出来，在心血管系统中具有多种生理和病理生理功能。它在许多器官和组织中产生，包括脉管系统。ADM具有扩血管、利钠、抗细胞凋亡和促进NO生成等多种作用。它可能在各种心血管疾病中起保护作用，其血浆水平在高血压和心力衰竭患者中升高。ADM的给药是治疗心血管疾病的一种可能的治疗方法。许多研究已经调查了ADM在人体中的输注，其似乎对心力衰竭和心肌梗死有益。而不是ADM输注，其内源性水平的增加是另一种可能的策略。基因治疗在动物模型中是可行的，但其在人类中的应用是有限的。目前，ADM最有前景的临床应用是使用血浆中区域肾上腺髓质素前体水平作为心血管疾病的生物标志物。它是冠心病或心力衰竭患者预后和生存的良好指标。
The cardiovascular system is regulated by the autonomic nervous system, the renin–angiotensin–aldosterone system, nitric oxide (NO) and other factors including neuropeptides. Research in neurohumoral factors has led to the development of many cardiovascular drugs. Adrenomedullin (ADM), initially isolated from the adrenal gland, has diverse physiological and pathophysiological functions in the cardiovascular system. It is produced in many organs and tissues including the vasculature. ADM has numerous actions, including vasodilation, natriuresis, antiapoptosis and stimulation of NO production. It might play a protective role in various cardiovascular pathologies, and its plasma level is elevated in patients with hypertension and heart failure. Administration of ADM is a possible therapeutic approach for treating cardiovascular diseases. A number of studies have investigated the infusion of ADM in humans, which seems to be benficial in heart failure and myocardial infarction. Instead of ADM infusion, augmentation of its endogenous level is another possible strategy. Gene therapy is feasible in animal models, but its application in humans is limited. At present, the most promising clinical application of ADM is the use of the plasma level of mid-regional proadrenomedullin as a biomarker in cardiovascular diseases. It is a good marker of prognosis and survival in patients with coronary aretery disease or heart failure.