Responses of atrial natriuretic peptide and brain natriuretic peptide to exercise in patients with chronic heart failure and normal control subjects

Steele, I. C.; McDowell, Garry; Moore, Allan F.; Campbell, N. P. S.; Shaw, Cheng‐Mei; Buchanan, K.D.; Nicholls, D. P.

doi:10.1046/j.1365-2362.1997.1070653.x

Cited by 67 publications

(45 citation statements)

References 38 publications

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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%

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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Section: Discussionmentioning

confidence: 99%

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

et al. 2002

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“…Exercise, fluid intake, and fluid infusion affect plasma BNP and NT-proBNP concentrations to some extent. Exercise increased plasma BNP concentrations by 10 -30% in a short time period in heart failure patients (25,26 ), but this increase does not seem to occur in healthy individuals (25)(26)(27). Saline infusions increase plasma NT-proBNP, and possibly also D), individual median within-day, day-to-day, and week-to-week NT-proBNP/BNP ratios plotted vs the individual median within-day, day-to-day, and week-to-week concentrations of BNP (n ϭ 112) and NT-proBNP (n ϭ 112), respectively.…”

Section: Discussionmentioning

confidence: 99%

High Intraindividual Variation of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in Patients with Stable Chronic Heart Failure

Bruins

Fokkema

Römer³

et al. 2004

Clinical Chemistry

199

151

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Methods:We recruited 43 patients with stable chronic heart failure living in Curaçao (22 males, 21 females; median age, 63 years; range, 20 -86 years; New York Heart Association classes I-III). Samples were collected for within-day CV i (n ‫؍‬ 6; every 2 h starting at 0800), day-to-day CV i (n ‫؍‬ 5; samples collected between 0800 and 1000 on 5 consecutive days), and week-to-week CV i (n ‫؍‬ 6; samples collected between 0800 and 1000 on the same day of the week for 6 consecutive weeks). NT-proBNP (Roche) and BNP (Abbott) were measured by immunoassay. Results: Median (range) concentrations were 134 (0 -1630) ng/L (BNP) and 570 (17-5048) ng/L (NT-proBNP). Analytical variation, week-to-week CV i , and reference change values were 8.4%, 40%, and 113% (BNP), and 3.0%, 35%, and 98% (NT-proBNP). Week-to week CV i s were inversely related to median BNP concentrations. Week-to week CV i s for BNP were 44% (BNP <350 ng/L)

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“…Peak oxygen consumption (peak VO 2 ) was defined as the highest VO 2 value averaged over 15 seconds during the final minute of exercise. [17][18][19][20] Statistics: All date are were expressed as the mean±standard deviation (SD). A value of p<0.05 was considered statistically significant.…”

Section: )mentioning

confidence: 99%

<b>Plasma Natriuretic Peptide Levels and Daily Physical Activity in Patients with Pacemaker Implantation</b>

Seino

Ogura

et al. 2001

Jpn Heart J

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SUMMARYTo determine whether plasma ANP and/or BNP levels can be used to detect limitations in daily physical activity after pacemaker implantation, we measured plasma ANP and BNP levels at a pacemaker follow-up clinic in 56 patients (62±15 yrs, 2AAI, 9VVI, 34DDD, 7VDD and 4 rate-responsive modes). daily physical activity evaluated by a specific activity scale questionnaire (METs) and VO 2 max obtained by expired gas analysis during ergometer exercise.A very clouse correlation (n=6, r=0.89, p<0.05) was obseved between. ANP in patients with daily physical activity class III (2-4 METs, n=21) was significantly higher than class II (5-6 METs, n=23, p<0.01) and class I (>7 METs, n=8, p<0.01), while BNP in class III patients was significantly higher than in class II (p<0.0001) and class I (p<0.0001) patients. Significant correlations between daily physical activity and BNP (r=-0.64, p<0.0001) and ANP (r=-0.43, p<0.001) were observed. Physiological pacing mode did not necessarily offer a better profile for BNP levels compared with non-physiological pacing modes. Patients with ventricular pacing (wide QRS: VDD, RR-VVI and VVI) showed significantly high ANP (p<0.01) and BNP (p<0.01) levels compared with those in patients with atrial pacing (narrow QRS: AAI and RR-AAI). During exercise, plasma catecholamines and ANP levels were significantly elevated, however, BNP levels, which were already elevated at rest, did not change significantly, and reflected a limitation of daily physical activity. The present study revealed that 37.5% of the patients displayed an elevation in BNP and this was judged to be a limitation of physical activity class III being equivalent to NYHA II or more. Elevated resting BNP levels reflected a limitation in daily physical activity in these patients. These findings suggested a third condition for physiological pacing-synchronization of ventricular contraction (narrow QRS pacing) -in addition to the two conventional conditions of atrioventricular synchrony and rate-responsiveness. (Jpn Heart J 2001; 42: 471-482) Key words: Physiological pacing, Brain natriuretic peptide, Congestive heart failure, Physical activity, Dyssynchronization WE have reported that the electrophysiological consequences of the heart following pacemaker implantation are closely related to the cardiodynamic and neuFrom

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Responses of atrial natriuretic peptide and brain natriuretic peptide to exercise in patients with chronic heart failure and normal control subjects

Cited by 67 publications

References 38 publications

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

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

High Intraindividual Variation of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in Patients with Stable Chronic Heart Failure

<b>Plasma Natriuretic Peptide Levels and Daily Physical Activity in Patients with Pacemaker Implantation</b>

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