Abstract: Objective To observe the changes of plasma adrenomedu (AM), endothelin (ET) and angioteusin Ⅱ (Ang Ⅱ) in patients with congestive heart failure(CHF). Methods Plasma AM, ET and Ang Ⅱ levels were determined by radioimmuncassay in 95 patients with CHF and 50 healthy control subjects. In 95 patients with CHF, the left ventricular ejection fraction (LVEF) of 56 patients was measured by echocardiography. Results The plasma AM levels were significantly higher in patients with CHF than that in control subjects. The increase of plasma AM, ET and Ang Ⅱ was parallel with the severity of CHF. There was a significant correlation between plasma levels of AM and ET (r=0.7218, P<0.01) and Ang Ⅱ (r=-0.6566, P<0.001). LVEF inversely correlated(r=-0.6258, P<0.001) with plasma AM levels and significantly positive correlated between the plains AM levels and the cardiothoracic ration(r=-0.6037, P<0.05) in patients with CHF. Conclusions These results suggest that AM might play a certain role in the pathophysiology of CHF. The elevated plasma ET and Ang Ⅱ may be responsible for the rise of plasma AM levels in patients with CHF.