Changes Of Concentration Of 20 Peptide At Proadrenomedullin N Terminal In Coronary Heart Disease Patients And Its Changes In Coronary Circulation

Objective: To investigate the concentration of 20 peptide at proadrenomedullin Nterminal (PAMP) and its changes in the course of coronary circulation in coronary heartdisease patients. Methods: In this selected series of patients, 16 patients were sufferingfrom acute myocardial infarction (AMI), 20 patients unstable angina (UA) and 18 patientsstable angina (SA). In another 20 patients who had.received coronary angiographyexamination and no obvious pathology lesion had been found were studied as control.Blood samples were collected from peripheral circulation, aortic, root (Ao) and coronarysinus (CS) during percutaneous coronary intervention (PCI) examination. Theconcentrations of PAMP,endothelin (ET) and angiotensinⅡ(AngⅡ) of plasma in thesamples were measured by the radioimmunoassay respectively. The differences ofconcentrations between sino-arterial (CS-Ao) samples represent PAMP,ET and AngⅡexcreted by local heart muscle in the process of coronary circulation. The results areanalyzed statistically. Results: The concentrations of PAMP at Ao and peripheralcirculation in patients with UA and AMI were significantly higher than that in controlgroup (P＜0.01). The concentrations of PAMP at CS in CHD groups(SA,UA,AMI)were significantly higher than that in control group(P＜0.01). The concentration ofPAMP in coronary sinus was higher than that in peripheral circulation and aorta root (P＜0.01) in CHD groups. The (CS-Ao) differences of PAMP in CHD groups were higherthan control group (P＜0.01). There are significant positive correlation among peripheralcirculation and coronary sinus. The (CS-Ao) differences of PAMP and Gensini Score (GS)were observed in patients with angina pectoralis. The concentration of PAMP in CS andlocal part of heart showed a positive correlation with ET and AngⅡ. Conclusion: ThePAMP levels of plasma in CHD patients are elevated as the PAMP had been secretedlocally after coronary circulation. The PAMP levels are related to severity of coronaryatherosclerosis and CHD groups(SA,UA,AMI) and showed a positive correlation withET and AngⅡThese results indicate that PAMP may be involved in the process ofpathophysiology in patients with coronary disease and may be one of the protectivemechanisms to the stabilization of internal environment of the organism. These resultsdenote that PAMP may be one of the important vasoactive substances in the progressionof CHD.