Aim To explore the changes of adrenomedullin （ADM） and neuropeptide Y （NPY） levels and further analyze the clinical significance in chronic heart failure （CHF） patients with elevated heart rate. Methods According to the result of 24-hour dynamic electrocardiogram examination on admission CHF patients between 2011 and 2012,80 patients whose average heart rate was more than 80 bpm were divided into the elevated heart rate group and another 80 patients whose heart rate was low than 80 bmp as control group. Every subject’s plasma ADM, NPY and brain natriuretic peptide （BNP） were detected by enzyme-linked immunosorbent assay （ELISA）. The parameters of left atrial diameter （LAD）, left ventricle end-diameter （LVED）, left ventricle ejection fraction （LVEF）, fraction shortening （FS） were detected by echocardiography. Results The plasma ADM, NPY levels increased with the cardiac functional grading （P<0.01） There is a significant difference between two groups compared by independent t-test. The elevated heart rate group had higher levels of plasma ADM and NPY than control group （P<0.05）. The levels of ADM and NPY were positively correlated with LAD （P<0.001）, and negatively correlated with LVEF and FS （P<0.001）. Conclusion ADM and NPY may be involved in the pathophysiologic processes of CHF with elevated heart rate which are risk factors for developing heart failure.