| Objective To investigate the relationship between cardiac function and ADM, ANP and ET-1 levels in the pericardial fluid of patients with heart failure.Methods Sixty-five patients with heart disease being undergone cardiac surgery were enrolled. Pericardial fluid and blood samples were taken before pericardiotomy. Cardiac functions of all patients were classified according to the standard of NYHA. The levels of ADM, ANP and ET-1 of pericardial fluid and blood were determined by radio- immunoassay.Results (1) ir-ADM, ir-ANP and ir-ET-1 levels in the pericardial fluid were found significantly higher than those in the serum (P<0.01). (2) ADM and ANP levels in the pericardial fluid were positively correlated to the cardiac function, and were significantly positively correlated to left ventricular ejection fraction (LVEF)(r=-0.625,P<0.01), while ET-1 level in the pericardial fluid was negatively correlated to the cardiac function (r=-0.49, P<0.05). (3) ADM level in the pericardial fluid was positively correlated to ANP level in the pericardial fluid(r=0.408,P<0.01). (4) ADM level in the pericardial fluid was negatively correlated to ET-1 level in the pericardial(r=-0.502,P<0.01). (5) There was no statistic difference in ADM levels of pericardial fluid between coronary artery disease and rheumatic valve disease (t=1.78,P>0.05).Conclusions There are higher concentrations of ir-ADM, ir-ANP and ir-ET-1 in the pericardial fluid than those in the serum. ADM and ANP levels in the pericardial fluid are positively correlated to the severity of cardiac failure, and are significantly negatively correlated to left ventricular ejection fraction (LVEF), while ET-1 level in the pericardial fluid is negatively correlated to the severity of cardiac failure. Increased ADM, ANP and ET-1 in pericardial fluid of patients with heart failure may play an important role in heart failure as autocrine or paracrine .
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