Plasma mid-regional pro-adrenomedullin levels are inversely associated with anxiety but unrelated to depression: Results from the observational DIAST-CHF study in patients with cardiovascular risk factors.

Abstract

OBJECTIVES:

It has been postulated that patients with heart failure have a high risk of ventricular arrhythmias and sudden cardiac death resulting from anxiety-induced autonomic arousal. In the prospective and multicenter DIAST-CHF (Diagnostic Trial on Prevalence and Clinical Course of Diastolic Dysfunction and Heart Failure) study, we therefore, tested the hypothesis that adrenomedullin (ADM), a well-established predictor for cardiovascular outcome, is associated with self-rated anxiety symptoms in patients at risk of suffering from or actually with overt heart failure.

PARTICIPANTS AND MEASURES:

Study participants with risk factors for diastolic dysfunction were requested to complete the Hospital Anxiety and Depression Scale (HADS), and plasma mid-regional pro-adrenomedullin (MR-proADM) concentrations were measured.

RESULTS:

In bivariate analysis, we found significantly lower plasma MR-proADM levels in patients with elevated HADS-anxiety scores above the clinically relevant cut-off level of ≥11 (n=118, 536pmol/l, interquartile range [IQR] 449-626) as compared to non-anxious study participants (n=1,292, 573pmol/l, IQR 486-702, p=0.001). A set of multivariate models adjusted for potential confounders confirmed the negative association between self-rated anxiety symptoms and plasma MR-proADM. In similar models, no significant association was detected between HADS-depression scores and MR-proADM.

CONCLUSIONS:

The inverse relationship between plasma MR-proADM and anxiety observed in patients with cardiovascular risk factors supports a previous experimental study using a mutant mouse line with a brain-specific loss of ADM expression which displayed hyperactive and over-anxious behavior. Further experimental and clinical studies are warranted to test the hypothesis that also in humans ADM acts as a neuromodulator with anxiolytic properties.

• Authors: Thomas Meyer, Christoph Herrmann-Lingen, Mira-Lynn Chavanon, Burkert Pieske, Rolf Wachter, Frank Edelmann
• Journal: Psychoneuroendocrinology (Psychoneuroendocrinology) Vol. 62 Pg. 227-32 (Dec 2015) ISSN: 1873-3360 [Electronic] England
• PMID: 26342564 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015. Published by Elsevier Ltd.

Chemical References

• ADM protein, human
• Adrenomedullin

Topics

• Adrenomedullin (blood)
• Aged
• Aged, 80 and over
• Anxiety (blood, diagnosis)
• Cardiovascular Diseases (blood)
• Depression (blood, diagnosis)
• Diagnostic Self Evaluation
• Female
• Humans
• Male
• Middle Aged
• Prospective Studies
• Risk Factors