Biomed. Papers 147(1), 71-75 (2003) | DOI: 10.5507/bp.2003.010

APPLICATION OF DETERMINED NT-proBNP IN PHYSICAL STANDARDIZED EXERCISE

Josef Barteka, David Stejskalc, Borek Lačňákb, Renata Jurákovác
a Institute of Medical Chemistry and Biochemistry, Faculty of Medicine, Palacky University Olomouc
b Department of Internal Medicine, Hospital Šternberk
c Department. of Laboratory Medicine, Hospital Šternberk
d Clinic of Internal Medicine, Hospital Zlín

Natriuretic peptides can be used as markers of heart failure, its severity and also in the differential diagnosis of dyspnea. Moreover, the dynamics of natriuretic peptides in physical standardized exercise may be used in the assessment of latent heart failure. Aim of the study: Can determination of NT-proBNP be used in the diagnosis of exercise-induced ischemia or latent heart failure? 18 probands (10 men, 8 women) under study were risk persons with unspecified ECG, without signs of manifest heart failure. They were subjected to ergometric bike exercises up to the subjective maximum, SPECT myocardium with estimated ejection fraction of the left ventricle at peak ergometric exercise. The following parameters were followed-up: a) before ergometric exercise: NT-proBNP, CRP, TNF-α, Hb, Htc, lactate b) at subjective maximum: NT-proBNP, Hb, Htc, lactate c) 30 min after stopping the exercise: NT-proBNP d) 60 min after stopping the exercise: NT-proBNP. The volume blood changes were taken into account (estimation from the dynamics of Htc, Hb with calculation of metabolic changes of NT-proBNP). To evaluate the dynamics of NT-proBNP, the group was divided into subgroups according to the results obtained in ergometric exercises.

Results: initial values of NT-proBNP within normal limits (< 59 pmol/l, 500 ng/l) in 94%, the submaximal pulse rate was reached in 94%, ischemic changes in ECG were observed in 59%, typical clinical signs of heart ischemia were recorded in 35%. Signs of heart dysfunction according to SPECT were found in 47% and ischemic symptoms were observed in 43%. In general, the plasmatic volume decreased by 24% at maximal exercise. Lactate concentration in the plasma increased in all cases. Conversion of NT-proBNP into volume blood changes revealed that increased NT-proBNP occurred only in 22%. Differences between NT-proBNP before exercises and at maximal exercise prior and after correction into volume blood changes were statistically insignificant. 30 and 60 min after the exercise, no significant differences were found in NT-proBNP concentrations. Dividing into subgroups according to the results of ergometric exercises, showed no significant differences in NT-proBNP concentrations. Dynamics of NT-proBNP changes during and after ergometric exercises cannot be used for the diagnosis of exercise-induced heart failure. The high stability of NT-proBNP related to physical activity was confirmed.

Keywords: NT-pro BNP, Exercise-induced ischemia, Latent heart failure

Published: November 1, 2003  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Bartek, J., Stejskal, D., Lačňák, B., & Juráková, R. (2003). APPLICATION OF DETERMINED NT-proBNP IN PHYSICAL STANDARDIZED EXERCISE. Biomedical papers147(1), 71-75. doi: 10.5507/bp.2003.010
Download citation

References

  1. Friedl W, Mair J, Thomas S. (2001) Relationship between Natriuretic peptides and hemodynamics in patients with heart failure at rest and after ergometric excercise. Clin Chem 38, 94-102.
  2. Kelly R. (2001) Are natriuretic peptides clinically useful as markers of heart? Ann Clin Biochem 38, 94-102. Go to original source... Go to PubMed...
  3. Maisel A. (2002) Measurement of B-type natriuretic peptide (BNP) levels can help differentiate pulmonary from cardiac causes of acute dyspnea. J Am Coll Cardiol 39, 202-209.
  4. Lim PO, Donnan PT, Struthers AD, MacDonald TM. (2002) Exercise capacity and brain natriuretic Peptide in hypertension. J Cardiovasc Pharmacol 40, 519-527. Go to original source... Go to PubMed...
  5. Kohno M, Yasunari K, Yokokawa K, Horio T, Kano H, Minami M, Ikeda M, Yoshikawa J. (1996) Plasma brain natriuretic peptide during ergometric exercise in hypertensive patients with left ventricular hypertrophy. Metabolism 45, 1326-1329. Go to original source... Go to PubMed...
  6. Kruger S, Graf J, Kunz D, Stickel T, Hanrath P, Janssens U. (2002) Brain natriuretic peptide levels predict functional capacity in patients with chronic heart failure. J Am Coll Cardiol 40, 718-722. Go to original source... Go to PubMed...
  7. Steele IC, McDowell G, Moore A, Campbell NP, Shaw C, Buchanan KD, Nicholls D. (1997) Responses of atrial natriuretic peptide and brain natriuretic peptide to exercise in patients with chronic heart failure and normal control subjects. Eur J Clin Invest 27, 270-276. Go to original source... Go to PubMed...
  8. Yokoyama Y, Tanabe K, Yamada S, Itoh H. (1996) Changes in plasma level of brain natriuretic peptide during exercise in recovery phase of myocardial infarction and the clinical significance. J Cardiol 27, 121-131.
  9. Stejskal D, Oral I, Lačňák B, Juráková R, Horalík D, Adamovská S, Prošková J, Hrabovská I, Ožanová G. (2003) Vlastní zkušenosti s využitím stanovení NT-proBNP v klinické praxi. Vnitřní lék in press.
  10. Palyza V. (1985) Posuzování biochemických dat při objemových změnách krevních. Bioch Clin Bohemoslov 14, 189-219.