Abstract
The increasing prevalence of cardiovascular disease and concomitant chronic kidney disease among the aging populations is responsible for considerable growth of mortality. Additionally, frequent, prolonged hospitalizations and long-term treatment generates progressive decline in bodily functions as well as substantial public health and economic burden. Accessibility to easy, non-invasive prognostic markers able to detect patients at risk of cardiovascular events may improve effective therapy and mitigate disease progression. Moreover, an early diagnosis allows time for implementation of prophylactic and educational programs that may result in decreased morbidity, improved quality of life and reduced public health expenditure. One of the promising candidates for a novel cardiovascular biomarker is mid-regional proadrenomedullin, a derivative of adrenomedullin. Adrenomedullin is a peptide hormone known for its vasodilatory, antioxidant, antiapoptotic and antifibrotic effects. A remarkable advantage of mid-regional proadrenomedullin is its longer half-life which is a prerequisite for plasma measurements. These review aims to discuss the importance of mid-regional proadrenomedullin with reference to its usefulness as a biomarker of increased cardiovascular risk and kidney disease progression.
Highlights
The constantly growing world population and its parallel aging causes an increase in the number of chronically ill persons
Plasma ADM level increased in the early phase of acute myocardial infarction proportionally to its clinical severity and it was further elevated in patients with congestive heart failure
The results suggest that MR-ProADM and NT-proBNP could act as predictors of atrial fibrillation (AF) recurrence and may help to establish a therapeutic approach which is important to optimize treatment
Summary
The constantly growing world population and its parallel aging causes an increase in the number of chronically ill persons. Unhealthy lifestyle contributes to the development of hypertension (HT), diabetes mellitus, chronic kidney disease (CKD). The review aims to discuss the importance of mid-regional proadrenomedullin with reference to its usefulness as a biomarker of increased cardiovascular risk and renal disease progression. Growing amount of research confirms the expression of ADM receptors in many organs, including heart and vessels, muscles, endocrine glands, renal and nervous tissues. It was detected at low concentration in serum and other body fluids [5]. An amino-acid sequence known as mid-regional proadrenomedullin (MR-ProADM) is released in equal concentration to ADM in the process of proteolytic cleavage [6] It is a stable and inactive protein which can be detected. Majority of studies confirmed the significant relevance of MR-ProADM in the diagnosis, prognosis and estimation of mortality risk in hospitalized patients
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