Augmented Secretion of Atrial and Brain Natriuretic Peptides During Dynamic Exercise in Patients With Old Myocardial Infarction.

Marumoto, Kazumasa; Hamada, Mareomi; Aburaya, Masahito; Hiwada, Kunio

doi:10.1253/jcj.59.715

Cited by 20 publications

(18 citation statements)

References 34 publications

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“…Our results also showed that following a single session of HD there were still differences in the levels of both peptides between both groups regardless of the volume status. Since it seems that DW was correctly estimated in the majority of our patients and that a difference in hydration status between two groups was not present, based on the clinical evidence and our results that HD produced a similar increase in albumin or hematocrit in both groups, our findings are in agreement with those of previous studies that CAD has a direct effect on plasma levels of both peptides [15,16].…”

Section: Discussionsupporting

confidence: 92%

“…These parameters have been used in the past to estimate DW, based on the evidence that they are correlated with volume changes in HD patients [2,7,8,10,[12][13][14]. In patients with CAD, plasma levels of ANP and BNP are higher than those in control subjects [15][16][17][18], and CAD induces a disproportionate rise in ANP and BNP release after volume loading [19]. It has also been reported that the plasma levels of ANP induced by volume loading are markedly elevated especially in HD patients with concomitant cardiac disease [20].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Significance of Natriuretic Peptides and Cyclic GMP in Hemodialysis Patients with Coronary Artery Disease

et al. 2001

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Background: Plasma concentrations of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and cyclic guanosine monophosphate (cGMP) are suitable markers of ’dry body weight’ (DW) in hemodialysis (HD) patients. However, it is still unknown whether these markers can be applied to patients with renal failure and coronary artery disease (CAD). We examined the reliability of these peptides as volume markers in HD patients with CAD. We also assessed the relationship between natriuretic peptides and indices of left ventricular (LV) function. Methods: Plasma concentrations of ANP, BNP and cGMP were determined before and after HD in patients with CAD (group 1, n = 19, mean age 63 ± 12 years) and were compared with those of patients without cardiac disease (group 2, n = 20, age 61 ± 15 years). Using data obtained by cardiac catheterization, we examined the relationship between natriuretic peptides and indices of LV function in HD patients with CAD. Results: Baseline ANP (244 ± 205 pg/ml), BNP (713 ± 928 pg/ml) and cGMP (29.6 ± 21.6 pmol/ml) were significantly higher in group 1 than in 11 healthy volunteers (18.6 ± 9.9 pg/ml, 7.7 ± 7.6 pg/ml, cGMP 8.9 ± 4.9 pmol/ml, respectively). HD significantly reduced plasma ANP (87 ± 75 pg/ml) and BNP (477 ± 702 pg/ml) although they were still above normal control. HD reduced plasma cGMP (7.2 ± 4.5 pmol/ml) to normal values, suggesting the elimination of cGMP across the dialyzers. Baseline levels of ANP, BNP and cGMP in group 2 were less than those of group 1 but higher than the control. HD reduced natriuretic peptides in group 2 to levels lower than those in post-HD group 1. After HD, there was no significant correlation between reductions in body weight and changes in ANP or BNP. Baseline ANP and BNP levels closely correlated with pulmonary artery pressure, pulmonary artery wedge pressure, left ventricular end-diastolic pressure and left ventricular ejection fraction. A significant correlation was observed between BNP levels and the severity of CAD. Conclusion: ANP, BNP and cGMP seem to be a useful markers for fluid overload but not for DW in HD patients with CAD. Plasma ANP and BNP might be useful markers for left ventricular function.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Clinical Significance of Natriuretic Peptides and Cyclic GMP in Hemodialysis Patients with Coronary Artery Disease

et al. 2001

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“…37,38 However, exercise-induced BNP concentrations increase strikingly in patients with old myocardial infarction, 29 congestive heart failure 39 and hypertension, 38 but change little in normal subjects. 29,38,39 Morita et al 30 have also demonstrated that the increase in BNP levels is greater than ANP levels in patients with acute myocardial infarction, and concluded that the contribution of BNP to compensation of left ventricular dysfunction may be much greater than that of ANP. From these reports, it is presumed that the increase in exercise-induced BNP concentration reflects augmented myocardial stress.…”

Section: Discussionmentioning

confidence: 99%

“…26 -28 Plasma concentration of ANP increases with exercise while BNP concentrations increase strikingly with exercise in patients with old myocardial infarction, but change little in normal subjects. 29 Therefore, BNP may be a good marker for cardiac stress. 30 Also, since the increase in myocardial stress relates to exercise-induced vasoconstriction, we measured the levels of ET-1 (a potent vasoconstrictor) and blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Exercise prescription based upon cardiac vagal activity for middle-aged obese women

et al. 2002

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OBJECTIVE:The purposes of this study were to examine a new method to determine exercise intensity for obese people based on the cardiac vagal activity and to determine the effect of this approach on myocardial stress. SUBJECTS: Forty-three middle aged obese female volunteers (age 43.7 AE 6.5 y; height 1.56 AE 0.05 m; body mass 66.5 AE 9.3 kg; body mass index 27.3 AE 2.8 kg m 2 ; percentage body fat 40.7 AE 5.9%). MEASUREMENT: In the first experiment, 43 subjects performed a ramp exercise test on a bicycle ergometer with measurement of ECG and gas exchange parameters. In the second experiment, 11 subjects performed 45 min of constant walking exercise on a treadmill at a level corresponding to exercise intensity determined by vagal activity obtained from a ramp bicycle test. Blood pressure, endothelin 1 (ET-1), catecholamine, atrial natriuretic peptide (ANP), and brain natriuretic peptide (BNP) were measured before and after exercise. RESULTS: The heart rate variability power decreased with increasing work rate, and changed little after reaching individualspecific work rate. We presumed that vagal activity disappeared at this point and that the heart rate at this exercise intensity was determined as the vagal activity threshold (T VA ). The results showed a significant positive correlation (r ¼ 0.742, P < 0.0001) between T VA and ventilatory threshold (VT) heart rates, although the mean heart rate of T VA (114.3 AE 8.5 beats=min) was significantly lower (P < 0.001) than that at VT (119.0 AE 11.7), suggesting the cardiac vagal withdrawal occurred prior to the onset of lactate acidosis (lactic acid accumulation). Furthermore, exercise intervention experiment at T VA indicated that ET-1, catecholamine and BNP levels were not significantly different before and after exercise. However, ANP levels increased significantly after exercise (pre-exercise 18.6 AE 5.38 vs post-exercise 44.0 AE 24.87 pg=ml, P < 0.001), which in turn brought about a significant post-exercise reduction in the blood pressure (SBP 117.6 AE 13.7 vs 110.5 AE 7.4 mmHg, P < 0.05; DBP 78.6 AE 6.7 vs 73.5 AE 6.6 mmHg, P < 0.01). CONCLUSION: Our data suggest that it is possible to determine the exercise intensity (T VA ) on the basis of cardiac vagal response. These results also suggest that exercise at T VA level is a safe exercise intensity in the light of cardiac stress, and that T VA may be recommended for obese people who might possess lower cardiac sympatho-vagal activity.

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“…[1][2][3][4] It has been suggested that patients with CHD have exaggerated BNP or NT-proBNP secretion during transient myocardial ischaemia, [4][5][6][7][8][9][10] but this is controversial. 1 11-12 The exercise electrocardiographic tolerance test (ETT) remains a cornerstone in the diagnosis of CHD, as it is commonly available and cost effective.…”

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confidence: 99%

B-type natriuretic peptide in reversible myocardial ischaemia: Table 1

et al. 2006

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Background: Coronary heart disease is associated with increased B-type natriuretic peptides (BNPs), and, although controversial, may cause exaggerated exercise-induced BNP secretion. We investigated BNP in relation to reversible myocardial ischaemia. Materials and methods: Serum N-terminal proBNP (NTproBNP) was measured before and after an exercise electrocardiogram test (ETT) in 14 patients with and 45 patients without exercise-induced myocardial ischaemia. Statistical analysis was carried out on logarithmically transformed data. Results, however, are pre-transformed data.Results: NT-proBNP increased with exercise both in ETTpositive patients (mean (SD) 71.4 (41.2) v 76.8 (44.0) ng/l; p,0.001) and ETT-negative patients (54.0 (61.2) v 60.1 (69.0) ng/l; p,0.001). Pre-exercise and post-exercise NTproBNP were higher (p,0.05) in ETT-positive than in ETTnegative patients. Incremental NT-proBNP was similar in ETTpositive (4.7 (4.2) ng/l) and ETT-negative (6.2 (8.6) ng/l) patients. Conclusion: Serum NT-proBNP concentrations are higher in patients with exercise-induced myocardial ischaemia than in those without. Exercise-induced electrocardiographic myocardial ischaemia, however, is not associated with exaggerated BNP secretion.

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Augmented Secretion of Atrial and Brain Natriuretic Peptides During Dynamic Exercise in Patients With Old Myocardial Infarction.

Cited by 20 publications

References 34 publications

Clinical Significance of Natriuretic Peptides and Cyclic GMP in Hemodialysis Patients with Coronary Artery Disease

Clinical Significance of Natriuretic Peptides and Cyclic GMP in Hemodialysis Patients with Coronary Artery Disease

Exercise prescription based upon cardiac vagal activity for middle-aged obese women

B-type natriuretic peptide in reversible myocardial ischaemia: Table 1

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