1. bookVolume 22 (2014): Issue 1 (March 2014)
Journal Details
License
Format
Journal
eISSN
2284-5623
ISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
access type Open Access

The Effect of Maximal and Submaximal Exercise Testing on NT-proBNP Levels in Patients with Systolic Heart Failure

Journal Details
License
Format
Journal
eISSN
2284-5623
ISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
Abstract

Background: The submaximal exercise testing, four hundred meters walking test (400mWT), respectively six minutes walking test (6MWT) were proposed as an alternative to classical exercise stress testing on cycloergometer in heart failure patients. Purpose: to compare 400mWT and 6 MWT between them, but also with classical exercise stress testing on cycloergometer, by using amino-terminal pro-B-type natriuretic peptide values (NT-proBNP) before and after exercise. Method: 20 patients were studied with systolic heart failure (LVEF<40%), 16 males and 4 females aged 37-70 years. After the relief of congestive syndrome, each patient was submitted, on three consecutive days, to a classical cycloergometer exercise stress testing, 6 MWT and 400mWT. Plasma NT- proBNP levels were measured at rest and also immediately after exercise by using ELISA method. Results: NT-proBNP values on three consecutive days were already increased at rest. During exercise, NT-proBNP increased for cycloergometer from 688±72 fmol/ml to 1868±91 fmol/ml (p<0.05), for 6MWT from 843±90 fmol/ml to 977±93 fmol/ml (15%, p<0.05) and for 400mWT from 676±63 fmol/ml to 927±95 fmol/ml (37%, p<0.05). The correlation of the peak values of NT-proBNP on cycloergometer /6 MWT and for cycloergometer/ 400mWT was r=0.71; for 400mWT/6MWT r=0.81, p<0.01 . Conclusion: NT-proBNP concentrations increase significantly and similarly in patients with chronic heart failure, both during maximal and submaximal exercise. The two submaximal tests from the current study have a sufficient intensity in order to stimulate the release of the natriuretic cardiac peptides and may be used as alternative approaches to maximal exercise testing.

Keyword

Cuvinte cheie

1. Thygesen K, Mair J, Mueller C, Huber K, Weber M, Plebani, et al. Recommendations for the use of natriuretic peptides in acute cardiac care: a position statement from the Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care. Eur Heart J 2012;33(16):2001-6. DOI: 10.1093/ eurheartj/ehq50910.1093/eurheartj/ehq509Search in Google Scholar

2. Sudoh T, Maekawa K, Kojima M, Minamino N, Kangawa K, Matsuo H, et al. Cloning and sequence analysis of cDNA encoding a precursor for human brain natriuretic peptide. Biochem Biophys Res Commun. 1989;159(3):1427-34. DOI: 10.1016/0006-291X(89)92269-910.1016/0006-291X(89)92269-9Search in Google Scholar

3. Mair J. Biochemistry of B-type natriuretic peptide? where are we now? Clin Chem Lab Med 2008;46(11):1507-14.Search in Google Scholar

4. Clerico A, Emdin M. Diagnostic accuracy and prognostic relevance of the measurement of cardiac natriuretic peptides: a review. Clin Chem. 2004;50(1):33-50. DOI: 10.1373/clinchem.2003.02476010.1373/clinchem.2003.02476014633912Search in Google Scholar

5. Baicu CF, Zile MR, Aurigemma GP, Gaasch WH. Left ventricular systolic performance, function and contractility in patients with diastolic heart failure. Circulation. 2005;111(18):2306-12. DOI: 10.1161/01. CIR.0000164273.57823.26Search in Google Scholar

6. Zdrenghea D, Ilea M, Pop D, Petrovai D, Bodisz G, Zdrenghea M. N-terminal Pro B-type Natriuretic Peptide During Exercise In Patients With Systolic And Diastolic Heart Failure. Acta Endocrinologica (Buc). 2009;5(1):19-25. DOI: 10.4183/aeb.2009.1910.4183/aeb.2009.19Search in Google Scholar

7. Ilea M, Zdrenghea D, Bodisz G, Malai A, Gheorghiu L, Predescu D, et al. Cardiac peptides during exercise test in ischemic and non-ischemic heart failure patients. Rom J Intern Med. 2008;46(1):63-8.Search in Google Scholar

8. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K et al . The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012;33(14):1787-847. DOI: 10.1093/eurheartj/ehs10410.1093/eurheartj/ehs10422611136Search in Google Scholar

9. Zdrenghea D, Beudean M, Pop D, Zdrenghea V. Four hundred meters walking test in the evaluation of heart failure patients. Rom J Intern Med. 2010;48(1):33-8.Search in Google Scholar

10. Konstam MA. Natriuretic peptides and cardiovascular events:more than a stretch. JAMA. 2007;297(2):212-4. DOI: 10.1001/jama.297.2.21210.1001/jama.297.2.21217213406Search in Google Scholar

11. Guglin M, Hourani R, Pitta S. Factors Determin ing Extreme Brain Natriuretic Peptide Elevation. Congestive Heart Failure. 2007;13(3):136-41. DOI: 10.1111/j.1527-5299.2007.06478.x10.1111/j.1527-5299.2007.06478.x17541308Search in Google Scholar

12. Kallistratos MS, Pavlidis AN, Chamodraka ES, Varounis C, Dritsas A, Laoutaris ID, et al. Prognostic value of NT-proBNP at rest and peak exercise in patients with impaired left ventricular function. Angiology. 2012;63(7):516-21. DOI: 10.1177/000331971142932810.1177/000331971142932822156406Search in Google Scholar

13. Cipriano G Jr, Cipriano VT, da Silva VZ, Cipriano GF, Chiappa GR, de Lima AC, et al. Aerobic exercise effect on prognostic markers for systolic heart failure patients: a systematic review and meta-analysis. Heart Fail Rev. 2013 Oct 16 [Epub ahead of print]. DOI: 10.1007/s10741-013-9407-610.1007/s10741-013-9407-624129770Search in Google Scholar

14. Ingle L, Rigby AS, Carroll S, Butterly R, King RF, Cooke CB, et al. Prognostic value of the 6 min walk test and self-perceived symptom severity in older patients with chronic heart failure. Eur Heart J 2007;28(5):560-8. DOI: 10.1093/eurheartj/ehl52710.1093/eurheartj/ehl52717314108Search in Google Scholar

15. Hogenius J, Voors AA, Jaarsma T, Hillege HL, Boomsma F, van Veldhuisen DJ. Influence of age on natriuretic peptide in patients with chronic heart failure: a comparison between ANP/NT-ANP and BNP/NT-proBNP. Eur J Heart Fail. 2005;7(1):81-6. DOI: 10.1016/j.ejheart. 2004.03.014Search in Google Scholar

16. Magne J, Mahjoub H, Pibarot P, Pirlet C, Pierard LA, Lancellotti P. Prognostic importance of exercise brain natriuretic peptide in asymptomatic degenerative mitral regurgitation. Eur J Heart Fail. 2012;14(11):1293-302. DOI: 10.1093/eurjhf/hfs11410.1093/eurjhf/hfs11422782970Search in Google Scholar

17. Huang WS, Lee MS, Perng HW, Yang SP, Kuo SW, Chang HD. Circulating brain natriuretic peptide values in healthy men before and after exercise. Metabolism. 2002;51(11):1423-6. DOI: 10.1053/meta.2002.3519410.1053/meta.2002.3519412404192Search in Google Scholar

18. Krupicka J, Janota T, Kasalová Z, Hradec J. Effect of short-term maximal exercise on BNP plasma levels in healthy individuals. Physiol Res. 2010;59(4):625-8.10.33549/physiolres.93177319929142Search in Google Scholar

19. Foote RS, Pearlman JD, Siegel AH, Yeo KT. Detection of exercise-induced ischemia by changes in B-type natriuretic peptides. J Am Coll Cardiol. 2004 ;44(10):1980-7. DOI: 10.1016/j.jacc.2004.08.04510.1016/j.jacc.2004.08.04515542280Search in Google Scholar

20. Staub D, Jonas N, Zellweger MJ, Nusbaumer C, Wild D, Pfisterer ME, et al. Use of N-terminal pro-B-type natriuretic peptide to detect myocardial ischemia. Am J Med. 2005;118(11):1287. DOI: 10.1016/j.amjmed. 2005.05.020Search in Google Scholar

21. Mak GS, DeMaria A, Clopton P, Maisel AS. Utility of B-natriuretic peptide in the evaluation of left ventricular diastolic function: comparison with tissue Doppler imaging recordings. Am Heart J. 2004;148(5):895-902. DOI: 10.1016/j.ahj.2004.02.01610.1016/j.ahj.2004.02.01615523324Search in Google Scholar

22. Chinnaiyan KM, Alexander D, Maddens M, Mc- Cullough PA. Curriculum in cardiology: integrated diagnosis and management of diastolic heart failure. Am Heart J. 2007;153 (2):189-200. DOI: 10.1016/j. ahj.2006.10.022Search in Google Scholar

23. Zdrenghea D, Pop D, Ilea M. Cardiac Peptides During Isometric Exercise in Patients With Diastolic Dysfunction. Current Advances in Heart Disease. 2008;265-8.Search in Google Scholar

24. Danzig V, Míková B, Kuchynka P, Benáková H, Zima T, Kittnar O, et al . Levels of circulating biomarkers at rest and after exercise in coronary artery disease patients. Physiol Res. 2010;59(3):385-92.10.33549/physiolres.93176419681661Search in Google Scholar

25. Guazzi M, Vitelli A, Arena R. The effect of exercise training on plasma NT-pro-BNP levels and its correlation with improved exercise ventilatory efficiency in patients with heart failure. Int J Cardiol. 2012;158(2):290-1. DOI: 10.1016/j.ijcard.2012.04.09110.1016/j.ijcard.2012.04.09122608896Search in Google Scholar

26. Madaric J, Watripont P, Bartunek J, Casselman F, Vanderheyden M, Van Praet F, et al. Effect of mitral valve repair on exercise tolerance in asymptomatic patients with organic mitral regurgitation. Am Heart J. 2007;154(1):180-5. DOI: 10.1016/j.ahj.2007.03.05110.1016/j.ahj.2007.03.05117584574Search in Google Scholar

27. Mak GS, DeMaria A, Clopton P, Maisel AS. Utility of B-natriuretic peptide in the evaluation of left ventricular diastolic function: comparison with tissue Doppler imaging recordings. Am Heart J. 2004;148(5):895-902. DOI: 10.1016/j.ahj.2004.02.01610.1016/j.ahj.2004.02.016Search in Google Scholar

28. Suntharalingam J, Goldsmith K, Toshner M, Doughty N, Sheares KK, Hughes R, et al. Role of NT-proBNP and 6MWD in chronic thromboembolic pulmonary hypertension. Respir Med. 2007;101(11):2254-62. DOI: 10.1016/j.rmed.2007.06.02710.1016/j.rmed.2007.06.02717706409Search in Google Scholar

29. Frantz RP, McDevitt S, Walker S. Baseline NT-proBNP correlates with change in 6-minute walk distance in patients with pulmonary arterial hypertension in the pivotal inhaled treprostinil study TRIUMPH-1. J Heart Lung Transplant. 2012;31(8):811-6. DOI: 10.1016/j. healun.2012.04.005 Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo