Presence and severity of coronary artery disease and changes in B-type natriuretic peptide levels in patients with a normal systolic function.
B-type brain natriuretic peptide (BNP) levels increase during myocardial ischemia. Here, the authors undertook to evaluate the correlation between changes in plasma BNP levels during exercise and the presence and severity of coronary artery disease (CAD). The study subjects consisted of 159 hospitalized patients with a normal systolic function. Patients were allocated to a control group (N = 101, comprising patients with coronary artery stenosis of < 50%) or to a CAD group (N = 58, comprising patients with stenosis of > or = 50% or a greater coronary artery lesion). In addition, the CAD group was further subdivided into a single-vessel disease (VD) subgroup (N = 31) and a multi-VD subgroup (N = 27). All 159 study subjects underwent coronary angiography (CAG), and plasma BNP levels were measured before and immediately after exercise. A comparative study of BNP levels in the control and CAD groups before and after exercise revealed that BNP levels in the CAD group were significantly higher [22.4 (5.0-28.5) vs. 54.3 (13.1-74.6), P = 0.000; 35.0 (6.2-37.6) vs. 82.5 (23.2-102.8) pg/mL, P = 0.002, respectively]. Changes in BNP levels during exercise in the CAD group tended to be greater than in the control group, but without significance [12.6 (0-13.6) vs. 28.3 (2.8-25.5) pg/mL; P = 0.083]. Subgroup analysis showed that BNP levels tended to be positively related to the proportion of disease vessels, but statistical significance was only found between the control and multi-VD subgroup. Summarizing, this study shows that BNP level changes caused by exercise are closely related with the presence of CAD in patients with a normal systolic function. However, the relationship between these level changes and CAD severity requires further evaluation.
Kim
Bum Soo
BS
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. bsmed.kim@samsung.com
Lee
Hyun Jong
HJ
Shin
Hun Sub
HS
Yoon
Jang Hyuk
JH
Lee
Hyun Young
HY
Kim
Byung Jin
BJ
Sung
Ki Chul
KC
Kang
Jin Ho
JH
Lee
Man Ho
MH
Park
Jung Ro
JR
D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D023921:Coronary Stenosis / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013318:Stroke Volume; D013599:Systole / Q000502:physiology*
D020097:Natriuretic Peptide, Brain