Document Detail

Dynamic left ventricular dyssynchrony contributes to B-type natriuretic peptide release during exercise in patients with systolic heart failure.
MedLine Citation:
PMID:  18319268     Owner:  NLM     Status:  MEDLINE    
AIMS: Plasma B-type natriuretic peptide (BNP) is an emerging biomarker in heart failure. In this setting, the extent of left ventricular (LV) dyssynchrony contributes to exercise symptoms. Whether exercise-induced changes in LV dyssynchrony might be a trigger of BNP release has never been investigated. METHODS AND RESULTS: Fifty-seven patients with systolic LV dysfunction underwent quantitative analysis of BNP, mitral regurgitation (MR), and dyssynchrony at rest and during exercise. None had inducible ischaemia on perfusion imaging. By multiple regression analysis, end-systolic volume index (P < 0.0001), effective regurgitant orifice (ERO) (P < 0.001), and E/Ea (P = 0.002) emerged as independent determinants of BNP at baseline (R(2) = 0.67). Exercise induced a significant rise in BNP levels (P < 0.0001). In multivariate analysis, a smaller change in systolic blood pressure (P = 0.04), a larger increase in ERO (P = 0.017), and in systolic dyssynchrony index (P = 0.006) during exercise emerged as independent determinants of exercise-induced increases in BNP (R(2) = 0.45). CONCLUSION: MR severity, volume overload, and LV filling pressure are surrogates of BNP at rest. During exercise, changes in BNP reflect the presence of dynamic changes in both LV dyssynchrony and MR severity in the absence of inducible ischaemia.
Patrizio Lancellotti; Bernard Cosyns; Luc A Piérard
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-03-03
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  10     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-26     Completed Date:  2008-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  496-501     Citation Subset:  IM    
Department of Cardiology, University Hospital of Liège, CHU Sart Tilman, B-4000 Liège, Belgium.
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MeSH Terms
Aged, 80 and over
Biological Markers / blood
Exercise / physiology*
Exercise Tolerance / physiology
Heart Failure, Systolic / blood*,  etiology,  physiopathology*
Middle Aged
Mitral Valve Insufficiency / complications,  physiopathology
Multivariate Analysis
Natriuretic Peptide, Brain / blood*
Regression Analysis
Rest / physiology
Severity of Illness Index
Ventricular Dysfunction, Left / complications,  physiopathology*
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain

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