title: N-terminal pro-atrial natriuretic peptide and exercise prescription in patients with myocardial infarction.
abstract: BACKGROUND
  Left ventricular end-diastolic pressure (LVEDP) during exercise workload is an important parameter to guide an exercise prescription for patients with cardiovascular disease. Plasma levels of neuro-hormonal factors can be used as a reflection of real-time LVEDP, but its utility is limited by its short half-life. By contrast, the N-terminal fragment of pro-ANP (NT-ANP) has a longer half-life of 1 h.
  
  
  OBJECTIVE
  To determine whether plasma NT-ANP levels at 30 min after exercise can be used as a marker of LVEDP during peak exercise workload in patients with previous myocardial infarction.
  
  
  METHODS
  Twenty patients with a previous history of myocardial infarction.
  
  
  METHODS
  Cardiopulmonary exercise test was performed to determine peak VO(2) and anaerobic threshold. Plasma levels of ANP, BNP, NT-ANP, vasopressin and plasma catecholamine were measured at rest, maximum exercise, and 30 min after exercise (recovery).
  
  
  RESULTS
  With the exception of NT-ANP, the levels of each of neuro-hormonal factors peaked at maximum exercise and returned to baseline at recovery. By contrast, NT-ANP levels also increased at peak exercise but remained elevated at 30 min after exercise. Furthermore, NT-ANP levels at recovery correlated with ANP levels at maximum exercise (p<0.01, R=0.75), left ventricular ejection fraction (p<0.02, R=-0.54) and left ventricular systolic dimension (p<0.015, R=0.50).
  
  
  CONCLUSIONS
  Plasma NT-ANP levels at 30 min after exercise reflect ANP levels at maximum exercise and left ventricular overload during exercise. These data indicate that plasma NT-ANP after exercise may be a useful parameter to guide prescription of cardiac rehabilitation.
authors.affiliation: Cardiovascular Division, Department of Integrated Medicine I, Omiya Medical Center, Jichi Medical School, 1-847 Amanuma, Saitama, Saitama 330-8503, Japan.
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ikeda
authors.forename: Takanori
authors.initials: T
authors.lastname: Yasu
authors.forename: Toshio
authors.initials: T
authors.lastname: Nishikimi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kubo
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kawakami
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Momomura
authors.forename: Muneyasu
authors.initials: M
authors.lastname: Saito
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D001794:Blood Pressure; D002395:Catecholamines / Q000097:blood; D015444:Exercise; D005260:Female; D006207:Half-Life; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010101:Oxygen Consumption; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood*; D013997:Time Factors; D014667:Vasopressins / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000534:rehabilitation*
chemical_list: D002395:Catecholamines; D010446:Peptide Fragments; D011498:Protein Precursors; D014667:Vasopressins; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor