Physiological hypertrophy of the heart and atrial natriuretic peptide during rest and exercise.

Abstract

Atrial natriuretic peptide is a circulating hormone secreted by the atrial myocytes of the heart. It is released in response to increased atrial pressure,' which is generally equal to increased stretch and dilatation of the atrial wall. Plasma atrial natriuretic peptide rose during exercise.2The term "athelete's heart" was introduced byHenschen in 1899.' In this condition all the chambers of the heart are dilated and there is hypertrophy of the myocardium due to physical training.4"The purpose of this study was to determine whether the hypertrophy and dilatation of the heart seen in well trained persons influence the plasma concentration of atrial natriuretic peptide at rest or during exercise.Requests for reprints to Dr Jens Svanegaard, Departnent of Cardiology, Odense University Hospital, Odense C, Denmark DK-5000.Accepteq for publication 27 June 1989 Patients and methods We studied six male footballers who trained strenuously and six normally active healthy matched controls (aged 21-30 years). None was taking medical treatment. The controls did not participate in any form of athletics for more than four hours a week. They all gave informed consent and the study was approved by the local ethics commnittee.All of the investigations were undertaken between 3 pm and 7 pm. Echocardiography, with cross sectional and M mode recordings, was performed with a Hewlett Packard 77020A ultrasonograph and a 3-5 MHz transducer on men in the supine position.All the M mode measurements originated from three or four consecutive cardiac cycles graded according to the system of the American Society of Echocardiography.

Double blind crossover comparison of the effects of dual chamber pacing (DDD) and ventricular rate adaptive (VVIR) pacing on neuroendocrine variables, exercise performance, and symptoms in complete heart block.

“…Dual chamber pacing in complete heart block restores atrial natriuretic peptide concentrations to normal in most patients and this has been offered as evidence of the physiological nature of this mode.22 By contrast, VVIR pacing did not restore normal concentrations. It has previously been shown that atrial natriuretic peptide concentrations rise on exercise23 24 and during ventriculoatrial pacing.25 By providing higher ventricular rates on exercise, VVIR pacing increases the frequency of asynchronous atrial contraction, which may result in an augmented rise in atrial natriuretic peptide on exercise even in the absence ofintact ventriculoatrial conduction. We did find a trend towards higher concentrations on exercise in the VVIR mode than in the DDD mode (exact p value = 005), but there was no difference between modes in either the absolute or percentage change on exercise.…”

“…Only one patient requested early crossover (5 4) 58-4 (6 0) Oxygen consumption at anaerobic threshold (ml/min/kg) 16-7 ( 0 9) 16-8 (0-9) Maximal carbon dioxide production (ml/min/kg) 24 from VVIR back to DDD for symptoms consistent with pacemaker syndrome. This was the only patient with evidence of intact ventriculoatrial (VA) conduction.…”

Endurance exercise training attenuates natriuretic peptide release during maximal effort exercise: biochemical correlates of the “athlete’s heart”

“…Similarly, resting levels of A-type NPs are driven by LA size in the setting of cardiovascular pathology (7,10). In contrast, resting levels of B-and A-type NPs are similar among endurance athletes with EICR and healthy normally active controls (1,24,31). This suggests that physiologic hypertrophy has different biochemical characteristics than pathologic hypertrophy.…”

“…However, the magnitude of MECPET-induced NP release was significantly lower following ET (Table 4). Specifically, MR-proANP increase from rest to peak exercise was reduced from 115 [95,127]% to 78 [59,87]%, (P ϭ 0.04), and NT-proBNP increase from rest to peak exercise was reduced from 46 [31,70]% to 27 [25,37]%, (P ϭ 0.02) (Figs. 2 and 3).…”

The effect of different exercise-testing protocols on atrial natriuretic peptide

“…In healthy subjects, trained and untrained individuals did not show differences in the concentration of plasma ANP at rest, or during any workload. The size of the chambers on the left side of the heart or left ventricular hypertrophy does not seem to influence the concentration of plasma ANP at rest or during exercise (Svanegaard et al. , 1989).…”