Document Detail


C-type natriuretic peptide expression in patients with chronic heart failure: effects of aerobic training.
MedLine Citation:
PMID:  18391643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: C-type natriuretic peptide (CNP) is structurally related to cardiac natriuretic peptides and is currently considered as an endothelium-derived hyperpolarizing factor. Endothelial dysfunction, commonly observed in chronic heart failure (HF) patients is positively affected by physical training. METHODS: To evaluate the effect of aerobic physical training on the expression of CNP, 90 HF patients on optimal pharmacological treatment (age 62+/-2 years, mean+/-SEM), randomly assigned in a 3 : 1 ratio to either control group (C, 19 patients) or home-based aerobic exercise-training program group (T, 71 patients), completed the protocol. Plasma assay of CNP, brain natriuretic peptide or B-type natriuretic peptide (BNP), and norepinephrine; echocardiogram; and cardiopulmonary-stress test were performed in all patients at enrollment and after 9 months. RESULTS: At baseline, in both groups, CNP plasma level was significantly related to BNP (R=0.50), ejection fraction (R=0.43), and peak oxygen uptake (VO2, R=0.43, all P<0.001). After 9 months, trained patients showed an improvement in peak VO2 (P<0.001) and ejection fraction (P<0.05), whereas norepinephrine (P<0.05), BNP (P<0.001), and CNP (P<0.001) decreased. No changes occurred in group C. In group T, the decrease in CNP was significantly related to the increase in peak VO2 (R=0.31, P<0.01), and the relation between CNP and BNP was preserved at the end of the program (R=0.41, P<0.001). CONCLUSION: Clinical and functional improvement after physical training in HF patients is associated with a decrease in adrenergic activation and in both CNP and BNP concentration. Changes in CNP plasma concentration after physical training might reflect an improvement in endothelial function.
Authors:
Claudio Passino; Silvia Del Ry; Silvia Severino; Alessandra Gabutti; Concetta Prontera; Aldo Clerico; Daniela Giannessi; Michele Emdin
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology     Volume:  15     ISSN:  1741-8267     ISO Abbreviation:  Eur J Cardiovasc Prev Rehabil     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-11     Completed Date:  2008-07-17     Revised Date:  2009-03-27    
Medline Journal Info:
Nlm Unique ID:  101192000     Medline TA:  Eur J Cardiovasc Prev Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  168-72     Citation Subset:  IM    
Affiliation:
Cardiovascular Medicine Department, CNR Institute of Clinical Physiology, Pisa, Italy. passino@ifc.cnr.it
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Cardiovascular Agents / therapeutic use
Chronic Disease
Down-Regulation
Echocardiography
Exercise Test
Exercise Therapy*
Female
Heart Failure / blood,  physiopathology,  therapy*
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Natriuretic Peptide, C-Type / blood*
Norepinephrine / blood
Oxygen Consumption
Prospective Studies
Stroke Volume
Time Factors
Treatment Outcome
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cardiovascular Agents; 114471-18-0/Natriuretic Peptide, Brain; 127869-51-6/Natriuretic Peptide, C-Type; 51-41-2/Norepinephrine

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