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学科主题: 临床医学
题名:
Midregional Pro-Adrenomedullin as a Predictor for Therapeutic Response to Midodrine Hydrochloride in Children With Postural Orthostatic Tachycardia Syndrome
作者: Zhang, Fengwen1; Li, Xueying2; Ochs, Todd3; Chen, Li1; Liao, Ying1; Tang, Chaoshu4; Jin, Hongfang1; Du, Junbao1,5
关键词: children ; midodrine hydrochloride ; midregional fragment of pro-adrenomedullin ; postural orthostatic tachycardia syndrome
刊名: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
发表日期: 2012-07-24
DOI: 10.1016/j.jacc.2012.04.025
卷: 60, 期:4, 页:315-320
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: SYNCOPE ; PLASMA ; MULTICENTER ; PROTEIN ; RATS
英文摘要:

Objectives This study was designed to explore the predictive value of the midregional fragment of pro-adrenomedullin (MR-proADM) in assessing the therapeutic efficacy of midodrine hydrochloride for children with postural orthostatic tachycardia syndrome (POTS).

Background Midodrine hydrochloride is an important therapeutic option for children with POTS. However, there has not been any method to predict response to the drug. The MR-proADM is produced in equimolar amounts to adrenomedullin (ADM), and directly reflects levels of the rapidly degraded active peptide, ADM.

Methods Fifty-seven children with POTS were designated as the POTS group. Twenty healthy children served as the control group. The children in the POTS group received midodrine hydrochloride treatment. The plasma concentration of MR-proADM was measured, using a sandwich immunoluminometric assay. A receiver-operating characteristic curve was used to explore the predictive value of MR-proADM.

Results Plasma levels of MR-proADM were significantly higher in children with POTS (75.0 [62.5 to 96.0] pg/ml) than in the control group (58.5 [50.3 to 69.0] pg/ml). Plasma levels of MR-proADM in responders to midodrine hydrochloride was significantly higher than that of nonresponders (76.0 [66.0 to 91.0] pg/ml vs. 59.0 [54.0 to 65.5] pg/ml, p < 0.01]. A receiver-operating characteristic curve on the predictive value of MR-proADM showed that the area under the curve was 0.879 with a 95% confidence interval of 0.761 to 0.997. Using a cutoff value for MR-proADM of 61.5 pg/ml produced both high sensitivity (100%) and specificity (71.6%) in predicting the efficacy of midodrine hydrochloride therapy for treating POTS.

Conclusions MR-proADM can help guide midodrine hydrochloride therapy in the management of POTS in children. (J Am Coll Cardiol 2012;60:315-20) (C) 2012 by the American College of Cardiology Foundation

语种: 英语
所属项目编号: 2011CB503904 ; 2012CB517806 ; 2012BA103B03 ; D10100050010059 ; 81121061
项目资助者: Major Basic Research Project of China ; National Twelfth Five-Year Plan for Science &amp ; Technology Support ; Beijing Science and Technology Project, China ; National Natural Science Foundation of China
WOS记录号: WOS:000306486300007
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55194
Appears in Collections:北京大学第一临床医学院_儿科_期刊论文

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作者单位: 1.Peking Univ, Dept Stat, Hosp 1, Beijing 100034, Peoples R China
2.Northwestern Univ, Chicago, IL 60611 USA
3.Minist Educ, Key Lab Mol Cardiol, Beijing, Peoples R China
4.Peking Univ, Dept Pediat, Hosp 1, Beijing 100034, Peoples R China
5.Peking Univ, Dept Physiol & Pathophysiol, Hlth Sci Ctr, Beijing 100034, Peoples R China

Recommended Citation:
Zhang, Fengwen,Li, Xueying,Ochs, Todd,et al. Midregional Pro-Adrenomedullin as a Predictor for Therapeutic Response to Midodrine Hydrochloride in Children With Postural Orthostatic Tachycardia Syndrome[J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY,2012,60(4):315-320.
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