Exercise-induced biphasic increase in circulating NT-proBNP levels in patients with chronic heart failure. 2008

Viviane M A Conraads, and Cathérine De Maeyer, and Paul Beckers, and Nadine Possemiers, and Manuella Martin, and Viviane Van Hoof, and Christiaan J Vrints
Department of Cardiology, Antwerp University Hospital, Belgium. Viviane.Conraads@uza.be

BACKGROUND Exercise increases natriuretic peptide levels in chronic heart failure (CHF) patients, but the effect is considered minor. We assessed acute and short-term release (<24 h) of NT-proBNP in CHF patients after a maximal cardiopulmonary exercise test (CPET) and 2 different submaximal training sessions. RESULTS 102 CHF patients either performed CPET (Group 1), a 1 h endurance (Group 2) or a combined endurance-resistance training session (Group 3). NT-proBNP concentration was determined before, at exercise cessation and after 18-22 h (Protocol A). In 20 patients, samples were obtained before, at exercise cessation, after 15, 30, 45, 60, 90 min, 2, 3, 4, 5, 6, 12, 22 h (Protocol B). Protocol A: At peak exercise, a 15%, 11% and 17% relative increase (p<0.001 vs baseline, all 3 groups) was seen, with a return to baseline after 18-22 h. The increase correlated with indicators of more advanced heart failure. Protocol B: A biphasic pattern was derived with a first peak within 1 h of exercise termination and a second peak (39%, 31% and 33% higher than baseline; p<0.05, all 3 groups) after 4-12 h. CONCLUSIONS The observed biphasic release of B-type natriuretic peptides supports standardization of sampling, taking recent exercise into account.

UI MeSH Term Description Entries
D010446 Peptide Fragments Partial proteins formed by partial hydrolysis of complete proteins or generated through PROTEIN ENGINEERING techniques. Peptide Fragment,Fragment, Peptide,Fragments, Peptide
D010807 Physical Endurance The time span between the beginning of physical activity by an individual and the termination because of exhaustion. Endurance, Physical,Physical Stamina,Stamina, Physical
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D006333 Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION. Cardiac Failure,Heart Decompensation,Congestive Heart Failure,Heart Failure, Congestive,Heart Failure, Left-Sided,Heart Failure, Right-Sided,Left-Sided Heart Failure,Myocardial Failure,Right-Sided Heart Failure,Decompensation, Heart,Heart Failure, Left Sided,Heart Failure, Right Sided,Left Sided Heart Failure,Right Sided Heart Failure
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015444 Exercise Physical activity which is usually regular and done with the intention of improving or maintaining PHYSICAL FITNESS or HEALTH. Contrast with PHYSICAL EXERTION which is concerned largely with the physiologic and metabolic response to energy expenditure. Aerobic Exercise,Exercise, Aerobic,Exercise, Isometric,Exercise, Physical,Isometric Exercise,Physical Activity,Acute Exercise,Exercise Training,Activities, Physical,Activity, Physical,Acute Exercises,Aerobic Exercises,Exercise Trainings,Exercise, Acute,Exercises,Exercises, Acute,Exercises, Aerobic,Exercises, Isometric,Exercises, Physical,Isometric Exercises,Physical Activities,Physical Exercise,Physical Exercises,Training, Exercise,Trainings, Exercise
D055070 Resistance Training A type of strength-building exercise program that requires the body muscle to exert a force against some form of resistance, such as weight, stretch bands, water, or immovable objects. Resistance exercise is a combination of static and dynamic contractions involving shortening and lengthening of skeletal muscles. Strength Training,Weight-Bearing Strengthening Program,Weight-Lifting Strengthening Program,Weight-Bearing Exercise Program,Weight-Lifting Exercise Program,Exercise Program, Weight-Bearing,Exercise Program, Weight-Lifting,Exercise Programs, Weight-Bearing,Exercise Programs, Weight-Lifting,Strengthening Program, Weight-Bearing,Strengthening Program, Weight-Lifting,Strengthening Programs, Weight-Bearing,Strengthening Programs, Weight-Lifting,Training, Resistance,Training, Strength,Weight Bearing Exercise Program,Weight Bearing Strengthening Program,Weight Lifting Exercise Program,Weight Lifting Strengthening Program,Weight-Bearing Exercise Programs,Weight-Bearing Strengthening Programs,Weight-Lifting Exercise Programs,Weight-Lifting Strengthening Programs
D020097 Natriuretic Peptide, Brain A PEPTIDE that is secreted by the BRAIN and the HEART ATRIA, stored mainly in cardiac ventricular MYOCARDIUM. It can cause NATRIURESIS; DIURESIS; VASODILATION; and inhibits secretion of RENIN and ALDOSTERONE. It improves heart function. It contains 32 AMINO ACIDS. Brain Natriuretic Peptide,Nesiritide,B-Type Natriuretic Peptide,BNP Gene Product,BNP-32,Brain Natriuretic Peptide-32,Natrecor,Natriuretic Factor-32,Natriuretic Peptide Type-B,Type-B Natriuretic Peptide,Ventricular Natriuretic Peptide, B-type,BNP 32,Brain Natriuretic Peptide 32,Natriuretic Factor 32,Natriuretic Peptide Type B,Natriuretic Peptide, B-Type,Natriuretic Peptide, Type-B,Natriuretic Peptide-32, Brain,Peptide, Brain Natriuretic,Peptide-32, Brain Natriuretic,Type B Natriuretic Peptide,Ventricular Natriuretic Peptide, B type

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