Plasma Adrenomedullin and Subclinical Cardiorenal Syndrome in Patients with Type 2 Diabetes Mellitus

Abstract

OBJECTIVE: To evaluate whether plasma adrenomedullin is involved in the previously reported significant inverse correlation between left ventricular (LV) end-diastolic pressure (peak velocity of early transmitral flow/peak velocity of early diastolic mitral annular motion ratio [E/E′]) and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus, mild-to-moderate renal function impairment and LV relaxation impairment (E′ ≤ 7.1 cm/s). METHODS: Plasma adrenomedullin concentration, E/E′ and eGFR were assessed in 82 patients with type 2 diabetes. RESULTS: Plasma adrenomedullin concentration was positively correlated with eGFR in patients with or without LV relaxation impairment, and inversely correlated with E/E′ in patients with LV relaxation impairment. Multivariate linear regression analysis supported a role for plasma adrenomedullin in the association between E/E′ and eGFR. CONCLUSION: These results support the hypothesis that adrenomedullin modulates the interaction between the heart and kidneys in early subclinical cardiorenal syndrome in patients with type 2 diabetes mellitus.