Exertional Changes in Circulating Cardiac Natriuretic Peptides in Patients with Suggested Coronary Artery Disease - 17/08/11
, Jacob E. Møller, MD, PhD , Kent R. Bailey, PhD †, Horng H. Chen, MD , John C. Burnett, MD , Patricia A. Pellikka, MD ⁎ 
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA Reprint requests: Patricia A. Pellikka, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905Résumé |
Background |
We measured plasma brain natriuretic peptide (BNP) and N-terminal atrial natriuretic peptide (ANP) levels before and after exercise stress testing and correlated results with echocardiographic evidence of ischemia.
Methods |
Sixty patients with left ventricular ejection fraction greater than 50% referred for clinically indicated exercise echocardiogram were studied. Peptides were measured at rest and 5 minutes after symptom-limited exercise.
Results |
Echocardiography was positive for ischemia in 19 (32%). With exercise, ANP level increased in all 60 patients (median at rest 2501 [799-6440]-3167 [977-8563] pg/mL after exercise [P < .0001]). BNP increased in 54 patients (90%) (19 [<3.9-213]-30 [<3.9-318] pg/mL [P < .0001]). In multivariable analysis, both exercise BNP level and exertional change in BNP were closely associated with rest BNP (P < .0001); both were also significantly associated with change in wall-motion score index and workload (P = .001 and P = .01, respectively). Exercise ANP was strongly related to rest level (P < .0001); change in ANP was related to workload (P < .0001).
Conclusion |
In patients with suggested coronary artery disease, exertional levels of BNP are influenced not only by development of stress-induced ischemia, but also by resting levels.
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| Supported by grants from Laval University, Québec, Canada (Dr Bergeron), Danish Heart Foundation (Dr Møller), Mayo Foundation, and American Heart Association, Northland Affiliate. |
Vol 19 - N° 6
P. 772-776 - juin 2006 Retour au numéro
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