Measurement of plasma adrenomedullin: A methodological reappraisal

Abstract: Plasma adrenomedullin (AM) levels are elevated in conditions of fluid overload such as heart failure (HF), chronic renal failure and hepatic failure. Because methodological problems reduce the introduction of AM assay in the clinical practice, we evaluated the analytical performance of a specific immunometric assay for AM and we studied 253 patients (130 with HF, 44 with chronic renal failure, 79 with hepatic disfunction) where increased AM levels are expected and 20 controls. In patients with HF (19.5+/-1.04 pmol/l), renal failure (65.4+/-5.63 pmol/l) and hepatic dysfunction (19.4+/-1.34 pmol/l) AM plasma concentrations were raised compared with controls (13.8+/-1.05 pmol/l). The sensitivity and reproducibility of the method for AM assay resulted suitable for reliably detecting changes in AM plasma levels in various disease conditions.