Document Detail

Plasma natriuretic peptide levels and daily physical activity in patients with pacemaker implantation.
MedLine Citation:
PMID:  11693283     Owner:  NLM     Status:  MEDLINE    
To determine whether plasma ANP and/or BNP levels can be used to detect limitations in daily physical activity after pacemaker implantation, we measured plasma ANP and BNP levels at a pacemaker follow-up clinic in 56 patients (62+/-15 yrs, 2AAI, 9VVI, 34DDD, 7VDD and 4 rate-responsive modes), daily physical activity evaluated by a specific activity scale questionnaire (METs) and VO2 max obtained by expired gas analysis during ergometer exercise. A very close correlation (n=6, r=0.89, p<0.05) was obseved between. ANP in patients with daily physical activity class III (2-4 METs, n=21) was significantly higher than class II (5-6 METs, n=23, p<0.01) and class I (>7 METs, n=8, p<0.01), while BNP in class III patients was significantly higher than in class II (p<0.0001) and class I (p<0.0001) patients. Significant correlations between daily physical activity and BNP (r=-0.64, p<0.0001) and ANP (r=-0.43, p<0.001) were observed. Physiological pacing mode did not necessarily offer a better profile for BNP levels compared with non-physiological pacing modes. Patients with ventricular pacing (wide QRS: VDD, RR-VVI and VVI) showed significantly high ANP (p<0.01) and BNP (p<0.01) levels compared with those in patients with atrial pacing (narrow QRS: AAI and RR-AAI). During exercise, plasma catecholamines and ANP levels were significantly elevated, however, BNP levels, which were already elevated at rest, did not change significantly, and reflected a limitation of daily physical activity. The present study revealed that 37.5% of the patients displayed an elevation in BNP and this was judged to be a limitation of physical activity class III being equivalent to NYHA II or more. Elevated resting BNP levels reflected a limitation in daily physical activity in these patients. These findings suggested a third condition for physiological pacing--synchronization of ventricular contraction (narrow QRS pacing)--in addition to the two conventional conditions of atrioventricular synchrony and rate-responsiveness.
X Wu; Y Seino; H Ogura; N Fukuma; T Katoh; T Takano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Japanese heart journal     Volume:  42     ISSN:  0021-4868     ISO Abbreviation:  Jpn Heart J     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-11-05     Completed Date:  2001-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401175     Medline TA:  Jpn Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  471-82     Citation Subset:  IM    
First Department of Medicine, Nippon Medical School, Tokyo, Japan.
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MeSH Terms
Atrial Natriuretic Factor / blood*
Catecholamines / blood
Exercise / physiology*
Heart Block / blood,  therapy
Middle Aged
Natriuretic Peptide, Brain / blood*
Pacemaker, Artificial*
Prospective Studies
Sick Sinus Syndrome / blood,  therapy
Reg. No./Substance:
0/Catecholamines; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

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