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(Hypertension. 1999;34:1147-1151.)
© 1999 American Heart Association, Inc.

Scientific Contributions

Orthostatic Stimuli Rapidly Change Plasma Adrenomedullin in Humans

Andreas Rössler; Zoltán László; Bernd Haditsch; Helmut G. Hinghofer-Szalkay

From the Volume Regulation and Space Medicine Research Group, Department of Physiology, School of Medicine (A.R.), Karl-Franzens University, Graz, Austria; the Third Department of Medicine, Semmelweis University Medical School (Z.L.), Budapest, Hungary; and the Institute for Adaptive and Spaceflight Physiology (B.H., H.G.H-S.), Austrian Society for Aerospace Medicine, Graz, Austria.

Correspondence to Andreas Rössler, Department of Physiology, School of Medicine, Karl-Franzens University, Harrachgasse 21, A-8010 Graz, Austria. E-mail andreas.roessler{at}kfunigraz.ac.at

Abstract—The aim of this study was to evaluate the effect of orthostasis on the time course of plasma adrenomedullin concentration. On 5 different days, normotensive subjects were randomized to undergo for 30 minutes either 12°, 30°, 53°, or 70° passive head-up tilt or to remain supine. Venous blood was collected from each subject in the supine position before tilting, at 3 and 27 minutes during tilting, and at 2 and 50 minutes after orthostasis. Plasma adrenomedullin increased significantly with tilt of 30° in a stimulus-dependent manner. Approximately half of the increase seen at 27 minutes occurred during the first 2 minutes of upright positioning; the maximum effect with 70° tilt was +70%. Elevations in norepinephrine, epinephrine, aldosterone, plasma renin activity, vasopressin, heart rate, and mean arterial pressure were also significant. Hematocrit, blood density, plasma density, and plasma volume loss rose (P<0.05) at 53° and 70° tilt. Our results indicate that adrenomedullin may play an important role in stabilization of hemodynamics during passive orthostasis. In conclusion, plasma adrenomedullin rapidly increases with orthostatic challenge in a stimulus-dependent manner and also swiftly returns to baseline levels after the subject resumes the supine position.

Key Words: tilt, head-up • adrenomedullin • barorereflex • volume, plasma • catecholamines

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