Document Detail

Postexercise ischemia is associated with increased neuropeptide Y in patients with coronary artery disease.
MedLine Citation:
PMID:  10961962     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Neurohormones may influence vascular tone both during and after exercise. Neuropeptide Y (NPY), which is costored and released with norepinephrine (NE) during sympathetic activity, is a potent vasoconstrictor with a relatively long half-life. We therefore examined its possible association with the ischemic response to exercise in patients with coronary artery disease. METHODS AND RESULTS: Twenty-nine male patients with effort-induced angina pectoris underwent a symptom-limited exercise test. In addition to conventional ST-segment analysis, we examined ischemia on the basis of heart rate (HR)-adjusted ST-segment changes through calculation of the ST/HR slope during the final 4 minutes of exercise and of the ST/HR recovery loop after exercise. Blood samples were taken before, during, and after exercise for an analysis of several neurohormones. Mean ST-segment depression was -223+/-20.2 microV (P:<0.0001) just before the termination of exercise, followed by a gradual normalization, but it remained significant after 10 minutes (-49+/-8.9 microV, P:<0.0001). At the end of exercise, the ST/HR slope, which reflects myocardial ischemia, was -6.0+/-0.77 microV/HR. In most patients, ST-segment levels at a given HR were lower during recovery than during exercise, here referred to as ST "deficit." Exercise increased the plasma levels of NPY, NE, epinephrine, and N-terminal proatrial natriuretic peptide, but big endothelin remained unchanged. Although NE and epinephrine peaked at maximal exercise, the highest levels of NPY and N-terminal proatrial natriuretic peptide were observed 4 minutes after exercise. The maximal increase in the NPY correlated significantly with ST-segment depression at 3 minutes after exercise (r=-0.61, P:= 0.0005), the ST deficit at the corresponding time point (r=-0.66, P:= 0.0001), and the duration of ST-segment depression after exercise (r= 0.42, P:=0.02). In contrast, no such correlations were found for NE. CONCLUSIONS: The present study has for the first time demonstrated a correlation between plasma NPY levels and the degree and duration of ST-segment depression after exercise in patients with coronary artery disease, which suggests that NPY may contribute to myocardial ischemia in these patients.
L Gullestad; B Jorgensen; T Bjuro; J Pernow; J M Lundberg; C D Dota; C Hall; S Simonsen; B Ablad
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  102     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-09-14     Completed Date:  2000-09-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  987-93     Citation Subset:  IM    
Department of Cardiology, Rikshospitalet University Hospital, Oslo, Norway.
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MeSH Terms
Analysis of Variance
Angina Pectoris / physiopathology
Atrial Natriuretic Factor / blood
Coronary Disease / blood,  physiopathology*
Endothelins / blood
Epinephrine / blood
Exercise Test*
Heart Rate
Middle Aged
Neuropeptide Y / blood*
Norepinephrine / blood
Protein Precursors / blood
Time Factors
Reg. No./Substance:
0/Endothelin-1; 0/Endothelins; 0/N-terminal proatrial natriuretic peptide; 0/Neuropeptide Y; 0/Protein Precursors; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 85637-73-6/Atrial Natriuretic Factor

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