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                 <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Bioactive adrenomedullin (bio-ADM) is a vascular-derived peptide hormone that has emerged as a promising biomarker for assessment of congestion in decompensated heart failure (HF). We aimed to evaluate diagnostic and prognostic performance of bio-ADM for HF in comparison to amino-terminal pro-B-type natriuretic peptide (NT-proBNP), with decision thresholds derived from invasive haemodynamic and population-based studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Normal reference ranges for bio-ADM were derived from a community-based cohort (n = 5060). Correlations with haemodynamic data were explored in a cohort of HF patients undergoing right heart catheterization (n = 346). Mortality and decision cutoffs for bio-ADM was explored in a cohort of patients presenting in the ER with acute dyspnoea (n = 1534), including patients with decompensated HF (n = 570). The normal reference range was 8\u201339 pg\/mL. The area under the receiver operating characteristic curve (AUROC) for discrimination of elevated mean right atrial pressure (mRAP) and pulmonary arterial wedge pressure (PAWP) was 0.74 (95% CI = 0.67\u20130.79) and 0.70 (95% CI = 0.64\u20130.75), respectively, with optimal bio-ADM decision cutoff of 39 pg\/mL, concordant with cubic spline analyses. NT-proBNP discriminated PAWP slightly better than mRAP (AUROC 0.73 [95% CI = 0.68\u20130.79] and 0.68 [95% CI = 0.61\u20130.75]). Bio-ADM correlated with (mRAP, r = 0.55) while NT-proBNP correlated with PAWP. Finally, a bio-ADM decision cutoff of 39 pg\/mL associated with 30 and 90 day mortality and conferred a two-fold increased odds of HF diagnosis, independently from NT-proBNP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Bio-ADM tracks with mRAP and associates with measures of systemic congestion and with mortality in decompensated HF independently from NT-proBNP. Our findings support utility of bio-ADM as a biomarker of systemic venous congestion in HF and nominate a decision threshold.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14018","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T02:19:06Z","timestamp":1659061146000},"page":"3543-3555","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Bioactive Adrenomedullin for Assessment of Venous Congestion in Heart Failure"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8357-5704","authenticated-orcid":false,"given":"Anna","family":"Egerstedt","sequence":"first","affiliation":[{"name":"Department of Cardiology, Clinical Sciences, Lund University , Lund ,","place":["Sweden"]},{"name":"Wallenberg Center for Molecular Medicine and Lund University Diabetes Center, Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Czuba","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinical Sciences, Lund University , Lund ,","place":["Sweden"]},{"name":"Wallenberg Center for Molecular Medicine and Lund University Diabetes Center, Lund University , Lund ,","place":["Sweden"]},{"name":"The Wallenberg Laboratory\/Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University and the Department of Cardiology, Sahlgrenska University Hospital , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Bronton","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sk\u00e5ne University Hospital , Malm\u00f6 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Lejonberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinical Sciences, Lund University , Lund ,","place":["Sweden"]},{"name":"Wallenberg Center for Molecular Medicine and Lund University Diabetes Center, Lund University , Lund ,","place":["Sweden"]},{"name":"Department of Cardiology, Helsingborg Hospital , Helsingborg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thoralph","family":"Ruge","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sk\u00e5ne University Hospital , Malm\u00f6 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torgny","family":"Wessman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sk\u00e5ne University Hospital , Malm\u00f6 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6ran","family":"R\u00e5degran","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinical Sciences, Lund University , Lund ,","place":["Sweden"]},{"name":"Department of Heart Failure and Valvular Disease, Sk\u00e5ne University Hospital , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janin","family":"Schulte","sequence":"additional","affiliation":[{"name":"SphingoTec GmbH , Hennigsdorf ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Hartmann","sequence":"additional","affiliation":[{"name":"SphingoTec GmbH , Hennigsdorf ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olle","family":"Melander","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sk\u00e5ne University Hospital , Malm\u00f6 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-9935","authenticated-orcid":false,"given":"J. Gustav","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinical Sciences, Lund University , Lund ,","place":["Sweden"]},{"name":"Wallenberg Center for Molecular Medicine and Lund University Diabetes Center, Lund University , Lund ,","place":["Sweden"]},{"name":"The Wallenberg Laboratory\/Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University and the Department of Cardiology, Sahlgrenska University Hospital , Gothenburg ,","place":["Sweden"]},{"name":"Department of Heart Failure and Valvular Disease, Sk\u00e5ne University Hospital , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"2026012114162056400_ehf214018-bib-0001","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.115.002922","article-title":"Fluid volume overload and congestion in heart failure: Time to reconsider pathophysiology and how volume is assessed","volume":"9","author":"Miller","year":"2016","journal-title":"Circ Heart Fail"},{"key":"2026012114162056400_ehf214018-bib-0002","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/ejhf.1369","article-title":"The use of diuretics in heart failure with congestion - a position statement from the heart failure Association of the European Society of cardiology","volume":"21","author":"Mullens","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2026012114162056400_ehf214018-bib-0003","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1161\/CIRCULATIONAHA.119.045409","article-title":"Altered hemodynamics and end-organ damage in heart failure: Impact on the lung and kidney","volume":"142","author":"Verbrugge","year":"2020","journal-title":"Circulation"},{"key":"2026012114162056400_ehf214018-bib-0004","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1002\/ejhf.872","article-title":"Organ dysfunction, injury and failure in acute heart failure: From pathophysiology to diagnosis and management. 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