Aerobic Training Decreases B-Type Natriuretic Peptide Expression and Adrenergic Activation in Patients With Heart Failure

Passino, Claudio; Severino, S; Poletti, Roberta; Piepoli, Massimo F; Mammini, C.; Clerico, Aldo; Gabutti, Alessandra; Nassi, G.; Emdin, Michele

doi:10.1016/j.jacc.2005.12.050

Cited by 170 publications

(170 citation statements)

References 18 publications

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“…25,26 Certainly, this scenario appears likely in cardiac failure where aerobic training decreases both circulating norepinephrine and NT-proBNP levels. 27 Any such associations are potentially important for UAE nationals since, as in our report, earlier studies suggest that physical activity levels are particularly low in this population 28,29 and may be linked to high levels of obesity and hypertension. 28,30 Regarding our second observation, there is little information, to our awareness, relating circulating levels of the cardiac natriuretic peptides to ethnicity.…”

Section: Discussionsupporting

confidence: 51%

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Plasma N terminal pro-brain natriuretic peptide levels and its determinants in a multi-ethnic population

et al. 2007

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This study documents the determinants and plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) among hypertensive and normotensive subjects in a multi-ethnic population in the United Arab Emirates (UAE). We obtained demographic, anthropometric and clinical data, together with fasting NT-proBNP and biochemical indices from 128 hypertensive patients and 138 normotensive subjects matched for age, gender and ethnicity. Plasma NT-proBNP levels were significantly (Po0.001), and several-fold higher among hypertensives (median 5.92, inter quartile range (IQR): 1.79-18.48 pmol/l) than normotensives (median 1.78, IQR: 0.59-4.32 pmol/l) in the total study population, and the same was true for the ethnic groups separately. Similarly, plasma levels of glucose, blood urea nitrogen (BUN) and creatinine, but not insulin, were significantly (Po0.05) higher among hypertensives than normotensives. For all subjects combined, log NT-proBNP correlated positively and significantly with age (Po0.01), log glucose (Po0.05), systolic blood pressure (SBP, Po0.001), log BUN (Po0.001) and log creatinine (Po0.001). Multivariate regression analysis showed that NT-proBNP levels were independently and positively correlated with SBP, age, gender, log BUN, Emirati and South East Asian ethnic groups and inversely associated with current exercise. In conclusion, we found circulating levels of NT-proBNP to be significantly increased in hypertensive versus normotensive subjects in the UAE and independently related to SBP, age, gender, indices of renal function and possibly exercise. Our results further suggest a possible modulating effect of ethnicity on NT-proBNP levels.

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Section: Discussionsupporting

confidence: 51%

“…Where no exact match was available priority was given to age and ethnicity. Thus, 61 Emirates, 57 nGAs, 59 Africans and 89 SEAs (26,27,27, 48 hypertensives, respectively) were selected.…”

Section: Methodsmentioning

confidence: 99%

Plasma N terminal pro-brain natriuretic peptide levels and its determinants in a multi-ethnic population

et al. 2007

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“…Very few studies have monitored the activation of circulating biomarkers in patients admitted to cardiac rehabilitation, and these have mainly involved small series of patients with heart failure and led to conflicting results. A recent study of 95 heart failure patients found that 9 months of aerobic training significantly reduced the plasma concentrations of BNP and norepinephrine, 28 and a study of 44 MI patients enrolled in an exercise-based rehabilitation program also found a reduction in BNP levels; 5 conversely, a study of physical training involving of other cells, including smooth muscle cells and fibroblasts. 20 In addition, neutrophils contain a store of mature protein in their specific granules and can promptly release the molecule in response to proinflammatory signals.…”

Section: Discussionmentioning

confidence: 99%

Pentraxin-3 Predicts Functional Recovery and 1-Year Major Adverse Cardiovascular Events After Rehabilitation of Cardiac Surgery Patients

Ferratini

Ripamonti

Masson

et al. 2012

Journal of Cardiopulmonary Rehabilitation and Prevention

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■ BACKGROUND: Inflammatory and vascular markers have proved to be predictors of outcome in myocardial infarction and heart failure. We evaluated several circulating markers of cardiac stress, inflammation, and endothelial function to investigate their ability to predict short-term functional recovery and long-term clinical outcome in heart surgery patients undergoing inpatient rehabilitation.■ METHODS: This prospective, multicenter study enrolled 223 patients after heart surgery, included in a 3-week program of standardized and supervised physical training. The association between biomarkers (pentraxin-3 [PTX3], brain natriuretic peptide, high-sensitivity cardiac troponin-T [hs-cTnT] and C-reactive protein [hsCRP], creatine kinase, myoglobin, and urinary albumin excretion [UACR]) and exercise capacity (6-minute walk test, 6MWT) or 1-year incidence of major adverse cardiovascular events (MACE) was tested in models that included biohumoral markers, and clinical and instrumental variables.■ RESULTS: The patients (69.5% men, mean age of 67 Ϯ 11 years) were enrolled after valvular surgery (52.7%) and 58.6% after coronary artery bypass grafting (CABG

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“…Therefore it is important to check whether each subject/patient has performed intense physical activity before cTn measurement. Troponin release after effort stress test may allow the identification of a subset of subjects at an increased risk of heart failure [57][58][59], and standardized physical effort with consequent cTn release variations may play an important prognostic role in patients with heart failure [57,58].…”

Section: Physical Exercisementioning

confidence: 99%

The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

Clerico

Zaninotto

Ripoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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According to recent international guidelines, including the 2012 Third Universal Definiton of Myocardial Infarction by the Joint ESC/ACCF/AHA/WHF Task Force, an increase in cardiac troponin (cTn) levels over the 99th percentile upper reference limit (99th URL) should be considered clinically relevant, this cut-off being measured with an imprecision ≤10 CV%. In theory 99th URL values strongly depend not only on demographic and physiological variables (i.e. criteria for considering the reference population "healthy"), but also on the analytical performance of cTn methods and mathematical algorithms used for the calculation. The aim of the present article was therefore to review the methodological and pathophysiological factors affecting the evaluation and calculation of the 99th URL for cTn assay. The critical analysis made showed that no uniform procedure is followed, and nor have experts or regulatory bodies provided uniform guidelines for researchers or cTn assays manufacturers as an aid in "their quest to define normality". In particular, little attention has been paid to the way in which a healthy reference population is to be selected, or the criteria for calculating the 99th URL value for cTn assays, thus highlighting the need for international recommendations not only for demographic and physiological variables criteria for defining a healthy reference population, but also for calculating mathematical algorithms for establishing/ calculating clinical decision values. An expert consensus group, comprising laboratory and clinical scientists, biomedical statisticians, industrial and regulatory representatives, should be responsible for drawing up these guidelines.

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Aerobic Training Decreases B-Type Natriuretic Peptide Expression and Adrenergic Activation in Patients With Heart Failure

Abstract: Clinical benefits after physical training in patients with HF are associated with blunting of adrenergic overactivity and of natriuretic peptide overexpression.

Cited by 170 publications

References 18 publications

Plasma N terminal pro-brain natriuretic peptide levels and its determinants in a multi-ethnic population

Plasma N terminal pro-brain natriuretic peptide levels and its determinants in a multi-ethnic population

Pentraxin-3 Predicts Functional Recovery and 1-Year Major Adverse Cardiovascular Events After Rehabilitation of Cardiac Surgery Patients

The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

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