INCREASED PLASMA-CONCENTRATION OF ADRENOMEDULLIN IN PATIENTS WITH SUBARACHNOID HEMORRHAGE

Adrenomedullin (AM) is a potent hypotensive peptide originally identif ied in pheochromocytoma tissues. Impaired cardiovascular conditions, s uch as hypertension, myocardial infarction, and septic shock, stimulat e production of AM. This study was performed to determine whether suba rachnoid hemorrhage (SAH) altered plasma AM concentration. Plasma conc entrations of AM in 17 patients with SAH were measured for 2 wk after the onset of SAH by AM-specific radioimmunoassay. Plasma concentration s of AM were increased in patients with SAH throughout the study perio d, compared with those in control subjects. Plasma concentrations of A M in patients classified as Hunt and Kosnik grade III or IV were signi ficantly higher than those classified as Hunt and Kosnik grade I or II on the day of and the day after the onset of SAH. However, plasma con centrations of AM were unaffected by angiographic vasospasm. These fin dings suggest that plasma concentrations of AM are increased in patien ts with SAH and may reflect the severity of SAH. Implications: Adrenom edullin has been reported to affect the cerebral circulation. This stu dy was performed to determine whether subarachnoid hemorrhage, a typic al cerebrovascular disorder, altered plasma adrenomedullin concentrati ons. We found that plasma adrenomedullin concentrations increased in p atients with subarachnoid hemorrhage, although no relationship was fou nd between plasma adrenomedullin concentration and angiographic :vasos pasm. Plasma adrenomedullin concentration may reflect the severity of hemorrhage.