Document Detail


N-terminal pro-atrial natriuretic peptide and exercise prescription in patients with myocardial infarction.
MedLine Citation:
PMID:  17292492     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left ventricular end-diastolic pressure (LVEDP) during exercise workload is an important parameter to guide an exercise prescription for patients with cardiovascular disease. Plasma levels of neuro-hormonal factors can be used as a reflection of real-time LVEDP, but its utility is limited by its short half-life. By contrast, the N-terminal fragment of pro-ANP (NT-ANP) has a longer half-life of 1 h. OBJECTIVE: To determine whether plasma NT-ANP levels at 30 min after exercise can be used as a marker of LVEDP during peak exercise workload in patients with previous myocardial infarction. PATIENTS: Twenty patients with a previous history of myocardial infarction. INTERVENTIONS: Cardiopulmonary exercise test was performed to determine peak VO(2) and anaerobic threshold. Plasma levels of ANP, BNP, NT-ANP, vasopressin and plasma catecholamine were measured at rest, maximum exercise, and 30 min after exercise (recovery). RESULTS: With the exception of NT-ANP, the levels of each of neuro-hormonal factors peaked at maximum exercise and returned to baseline at recovery. By contrast, NT-ANP levels also increased at peak exercise but remained elevated at 30 min after exercise. Furthermore, NT-ANP levels at recovery correlated with ANP levels at maximum exercise (p<0.01, R=0.75), left ventricular ejection fraction (p<0.02, R=-0.54) and left ventricular systolic dimension (p<0.015, R=0.50). CONCLUSION: Plasma NT-ANP levels at 30 min after exercise reflect ANP levels at maximum exercise and left ventricular overload during exercise. These data indicate that plasma NT-ANP after exercise may be a useful parameter to guide prescription of cardiac rehabilitation.
Authors:
Nahoko Ikeda; Takanori Yasu; Toshio Nishikimi; Tomohiro Nakamura; Norifumi Kubo; Masanobu Kawakami; Shin-ichi Momomura; Muneyasu Saito
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-01-12
Journal Detail:
Title:  Regulatory peptides     Volume:  141     ISSN:  0167-0115     ISO Abbreviation:  Regul. Pept.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-04-02     Completed Date:  2007-07-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8100479     Medline TA:  Regul Pept     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  154-8     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, Department of Integrated Medicine I, Omiya Medical Center, Jichi Medical School, 1-847 Amanuma, Saitama, Saitama 330-8503, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Natriuretic Factor / blood*
Blood Pressure
Catecholamines / blood
Exercise*
Female
Half-Life
Humans
Male
Middle Aged
Myocardial Infarction / blood*
Natriuretic Peptide, Brain / blood
Oxygen Consumption
Peptide Fragments / blood*
Protein Precursors / blood*
Time Factors
Vasopressins / blood
Ventricular Dysfunction, Left / rehabilitation*
Chemical
Reg. No./Substance:
0/Catecholamines; 0/Peptide Fragments; 0/Protein Precursors; 11000-17-2/Vasopressins; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

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