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Der Anaesthesist

, Volume 55, Issue 2, pp 171–178 | Cite as

Bedeutung von Adrenomedullin Pathogenese und Behandlung kardiovaskulärer Dysfunktionen der Sepsis

  • M. WestphalEmail author
  • J. Sander
  • H. Van Aken
  • C. Ertmer
  • H. D. Stubbe
  • M. Booke
Allgemeinanästhesie

Zusammenfassung

Adrenomedullin (AM) ist ein endogenes, vasodilatatorisches Peptidhormon, das eine Schlüsselrolle in der Regulation der kardiovaskulären und pulmonalen Hömöostase spielt. Klinische und experimentelle Untersuchungen haben gezeigt, dass AM eine alternative Therapieoption in der Behandlung des pulmonalen Hypertonus darstellt. Des Weiteren wurde AM bereits erfolgreich bei kardiovaskulären Erkrankungen, wie arterieller Hypertonie und Herzinsuffizienz nach Myokardinfarkt, eingesetzt. Neuere Untersuchungen weisen ebenfalls darauf hin, dass endogenes AM von besonderer Bedeutung in der Pathogenese sepsisassoziierter Beeinträchtigungen der systemischen Hämodynamik, des globalen Sauerstofftransports und der Mikrozirkulation ist. In tierexperimentellen Studien wurde außerdem gezeigt, dass sich die exogene Applikation von AM zur Prophylaxe und Therapie hypodynamer septischer Schockzustände eignet. Ziel dieser Arbeit ist es, das Molekül AM als regulatorisches endogenes Peptidhormon vorzustellen und die wichtigsten tierexperimentellen und klinischen Studien zu diskutieren, die eine Aussage zur Wirkung von AM bei kardiovaskulären Dysfunktionen und der Sepsis erlauben.

Schlüsselwörter

Adrenomedullin Multiorganversagen Pulmonale Hypertension Sauerstofftransport Sepsis 

Role of adrenomedullin in the pathogenesis and treatment of cardiovascular dysfunctions and sepsis

Abstract

Adrenomedullin (AM) is an endogenous vasodilatory peptide hormone, which plays a key role in the regulation and preservation of cardiovascular and pulmonary functions. Clinical and experimental studies have demonstrated that AM represents an alternative therapeutic option in the treatment of pulmonary hypertension. In addition, AM proved to be useful in the treatment of cardiovascular dysfunctions, such as arterial hypertension and congestive heart failure following myocardial infarction. Recent research has also shown that AM plays a pivotal role in the development of sepsis-associated hemodynamic and microcirculatory disorders. Experimental studies also suggest that infusion of exogenous AM might be a rational approach to prevent and treat hypodynamic septic shock. The objectives of this review article are to characterize the regulative properties of AM and to discuss clinical and experimental studies which allow to judge the role of AM in the setting of cardiovascular dysfunction and sepsis.

Keywords

Adrenomedullin Multiple organ failure Oxygen transport Pulmonary hypertension Sepsis 

Notes

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

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Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  • M. Westphal
    • 1
    • 3
    Email author
  • J. Sander
    • 1
  • H. Van Aken
    • 1
  • C. Ertmer
    • 1
  • H. D. Stubbe
    • 1
  • M. Booke
    • 2
  1. 1.Klinik und Poliklinik für Anästhesiologie und operative IntensivmedizinUniversitätsklinikumMünster
  2. 2.Klinik für AnästhesieKlinikum des Main-Taunus Kreises GmbHBad Soden
  3. 3.Klinik und Poliklinik für Anästhesiologie und operative IntensivmedizinUniversitätsklinikumMünster

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