Can exercise-induced changes in B-type natriuretic peptides be used to detect cardiac ischemia?
BACKGROUND
We reviewed the current medical literature that pertained to the question of whether myocardial ischemia triggers the release of B-type natriuretic peptides (BNPs) and, in particular, whether transient exercise-induced ischemia can be detected by the measurement of changes in these biomarkers. BNPs are well-established as markers of left ventricular dysfunction, particularly heart failure. There is accumulating evidence that various conditions with the common denominator of myocardial ischemia are also associated with increased circulating levels of these peptides.


RESULTS
Recently published methods and results, which includes our published and unpublished data, were reviewed.


CONCLUSIONS
The results show that exercise-induced ischemia or its associated regional wall-motion abnormalities trigger the release of BNPs and that the measurement of plasma levels of N-terminal pro brain natriuretic peptide and BNP before and immediately after symptom-limited exercise can distinguish patients with and without ischemia with a high degree of accuracy.
Yeo
Kiang-Teck J
KT
Department of Pathology, Dartmouth Medical School, Lebanon, NH 03756, USA.
Lee
Hong-Kee
HK
Wong
Kam-Cheong
KC
Foote
Robert S
RS
D000818:Animals; D015415:Biomarkers / Q000097:blood; D015444:Exercise / Q000502:physiology*; D006801:Humans; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012680:Sensitivity and Specificity
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain