Document Detail

Increased B-type natriuretic peptide is associated with an abnormal blood pressure response to exercise in asymptomatic aortic stenosis.
MedLine Citation:
PMID:  18077013     Owner:  NLM     Status:  MEDLINE    
AIMS: Both raised plasma levels of B-type natriuretic peptide (BNP) and an abnormal exercise response predict adverse clinical outcomes in aortic stenosis (AS). This study examines the relationship between the response to treadmill exercise and plasma levels of BNP in AS. METHODS AND RESULTS: 34 asymptomatic patients with moderate or severe AS (mean valve area 0.96+/-0.3 cm(2)) and 15 age matched controls underwent echocardiography, treadmill exercise testing, and BNP analysis. Compared to control subjects, AS patients had a higher left ventricular mass index, (133+/-50 vs 106+/-24 g/m(2), p=0.03), higher E/E' ratio, (10.6+/-3.6 vs 6.7+/-1.8, p=<0.0001), higher ejection fraction, (65+/-6 vs 59+/-6%, p=0.03), elevated resting BNP (11.4+/-6.5 vs 7.4+/-4.0 pmol/L, p=0.03) and shorter exercise duration (8.2+/-3.0 min vs 10.9+/-2.6 min, p=0.002). AS patients with an increase in systolic BP of <or=20 mmHg during exercise (n=18) had higher plasma levels of BNP than patients with an increase in systolic BP >20 mmHg (13.8+/-6.1 vs 8.6+/-6.0 pmol/L, p=0.003). The BNP measured at peak exercise was also associated with the BP response (p=0.003). The area under the receiver operator curve to predict an abnormal BP response to exercise was 0.82 for BNP measured at rest but only 0.46 for aortic valve area. There was a modest association between raised BNP and lower exercise capacity. CONCLUSION: In patients with AS there is an association between BNP and an abnormal BP response to exercise. Further study is needed to determine the incremental prognostic value of BNP and exercise testing in asymptomatic AS.
Niels C Van Pelt; Andrew J Kerr; Malcolm E Legget; Sanjeevan Pasupati; Gillian Whalley; Selwyn Wong; Irene Zeng; Ralph A H Stewart
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-20
Journal Detail:
Title:  International journal of cardiology     Volume:  127     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-30     Completed Date:  2008-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  313-20     Citation Subset:  IM    
Green Lane Cardiovascular Service, Auckland City Hospital, New Zealand.
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MeSH Terms
Aortic Valve Stenosis / blood*,  physiopathology
Blood Pressure / physiology*
Exercise / physiology*
Exercise Test / adverse effects*,  methods
Middle Aged
Natriuretic Peptide, Brain / blood*
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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