Determination of plasma adrenodullin in children with chronic heart failure

Aim: To investigate the changes of plasma adrenodullin (ADM) level in childrens with chronic heart failure (CHF)and clinical implications.Methods:A total of 42 childrens with CHF were enrolled in the study. The patients suffered from dilated cardiomyopathy, congenital heart defects, and other heart diseases. According to a modified scoring system described by Ross and Reithman, 16 patients were classified as class Ⅱ,14 as class Ⅲ,and 12 as class Ⅳ. Plasma levels of ADM were measured by radioimmunoassay assay in these patients and 11 healthy children. Echocardiography was performed to measure left ventricular function,and the ratio of E/A. The cardiothoracic ratio was measured by X-ray. Results: Plasma ADM levels of CHF patients were significantly elevated compared with control subjects ((218.27± 106.53) ng/L vs (74.39±53.99) ng/L, P=0.000). Plasma ADM level of CHF patients elevated with the severity of classification. The levels of ADM after treatment were much lower than those before treatment(P0.05). LVEF, FS,and E/A, and the levels of CTR in CHF patients were (38.36±13.58)%, (23.35±8.68)%, (1.54±0.16), (0.58±0.06). LVEF, FS, and E/A were significantly dereased and the levels of CTR were significantly increased with the severity of cardiac function classification. A significant correlation of plasma ADM level with LVEF (r=-0.69, P 0.001), E/A( r=0.34, P0.01), FS( r=-0.67, P0.001) and CTR (r=0.77, P 0.001) was observed.Conclusion: ADM play a compensatory and defensive role in the pathophysiology of the pediatric CHF. ADM may be not only a biochemical marker for evaluating the severity of CHF in children, but also a new prognostic indicator of this syndrome.