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.
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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)
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Copyright | Copyright © 2015. Published by Elsevier Ltd. |
Chemical References |
- ADM protein, human
- Adrenomedullin
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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
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