Document Detail


Relation of B-type natriuretic peptide levels before and after exercise and functional capacity in patients with idiopathic dilated cardiomyopathy.
MedLine Citation:
PMID:  17478157     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although much is known about the value of B-type natriuretic peptide (BNP) at rest, the significance of the responsiveness of BNP during exercise in patients with chronic heart failure (HF) without coronary artery disease remains to be established. A role of BNP release during exercise in the functional disability of patients with chronic HF and idiopathic dilated cardiomyopathy (IDC) was hypothesized. One hundred five consecutive patients with an established diagnosis of HF and IDC who underwent symptom-limited cardiopulmonary exercise testing were studied. BNP was measured immediately before exercise and within 1 minute of the end of exercise. BNP at rest increased significantly at peak exercise (median from 66.5 (first, third quartiles 18, 168) to 72.0 pg/ml (26, 208), p <0.001), but BNP response was not uniform. BNP response increased in 63% of patients, did not change in 22%, and decreased in 15%. BNP at rest and BNP response showed an inverse correlation (p <0.001, r = -0.523). Aging and low left ventricular ejection fraction were independent predictors of higher BNP levels at rest, but lower BNP response. Beta-blocker therapy did not influence BNP response. BNP at rest correlated negatively with functional capacity (p <0.001, r = -0.516), whereas BNP response correlated positively (p = 0.002, r = 0.326). Patients with BNP release (vs patients without) had higher maximum oxygen consumption (19.2 +/- 5.1 vs 15.9 +/- 3.6, p <0.001), better functional capacity (59 +/- 13% vs 50 +/- 15%, p = 0.002), and lower minute ventilation/carbon dioxide production slope (33.6 +/- 4.8 vs 36.5 +/- 7.7, p = 0.026) independent of other clinical parameters. In conclusion, BNP release during exercise could be a determinant of functional capacity in patients with chronic HF and IDC.
Authors:
Domingo A Pascual-Figal; Pablo Peñafiel; Gonzalo de la Morena; Belén Redondo; Francisco Nicolás; Teresa Casas; Mariano Valdés
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-03-15
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-04     Completed Date:  2007-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1279-83     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Department, Hospital Universitario Virgen de la Arrixaca, University of Murcia, Murcia, Spain. dapascual@servicam.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiomyopathy, Dilated / blood*,  physiopathology*
Exercise / physiology*
Exercise Test
Exercise Tolerance / physiology*
Female
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Oxygen Consumption / physiology
Pulmonary Gas Exchange / physiology
Rest / physiology*
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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