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Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Department of Physiology, Mayo Clinic and Foundation, Rochester, Minnesota 55905
Myocardial actions of the vasodilator
peptide adrenomedullin (ADM) in the intact animal are unknown. Negative
and positive inotropic actions have been reported in ex vivo
experiments. Myocardial and load-altering actions of ADM in dogs before
and after development of heart failure were studied. With
controlled heart rate (atrial pacing) and after
-blockade, ADM
was administered to five normal dogs in doses of 20 ng · kg
1 · min
1 iv, 100 ng · kg
1 · min
1 iv, and 200 ng · kg
1 · min
1 into the left
ventricle (LV). LV peak systolic pressure and end-systolic volume
decreased with each dose of ADM. End-systolic pressure decreased with
the two higher doses. At the highest dose, arterial elastance and the
time constant of LV isovolumic relaxation (
) decreased, and LV
end-systolic elastance (Ees) increased. LV
end-diastolic pressure and volume were unchanged. In five additional
normal dogs receiving only the highest dose of ADM (200 ng · kg
1 · min
1 intra-LV), to
control for increased heart rate and sympathetic activation observed
with the cumulative infusion, ADM produced arterial vasodilation but no
change in Ees or
. In four dogs with
pacing-induced heart failure, ADM (200 ng · kg
1 · min
1 intra-LV) was
without effect on
, Ees, and systolic or
diastolic pressure and volume. In vivo, ADM appears to be a selective
arterial dilator without inotropic or lusitropic effects. The
vasodilatory actions are attenuated in heart failure.
inotrope; hemodynamics
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