title: Exercise-induced biphasic increase in circulating NT-proBNP levels in patients with chronic heart failure.
abstract: BACKGROUND
  Exercise increases natriuretic peptide levels in chronic heart failure (CHF) patients, but the effect is considered minor. We assessed acute and short-term release (<24 h) of NT-proBNP in CHF patients after a maximal cardiopulmonary exercise test (CPET) and 2 different submaximal training sessions.
  
  
  RESULTS
  102 CHF patients either performed CPET (Group 1), a 1 h endurance (Group 2) or a combined endurance-resistance training session (Group 3). NT-proBNP concentration was determined before, at exercise cessation and after 18-22 h (Protocol A). In 20 patients, samples were obtained before, at exercise cessation, after 15, 30, 45, 60, 90 min, 2, 3, 4, 5, 6, 12, 22 h (Protocol B). Protocol A: At peak exercise, a 15%, 11% and 17% relative increase (p<0.001 vs baseline, all 3 groups) was seen, with a return to baseline after 18-22 h. The increase correlated with indicators of more advanced heart failure. Protocol B: A biphasic pattern was derived with a first peak within 1 h of exercise termination and a second peak (39%, 31% and 33% higher than baseline; p<0.05, all 3 groups) after 4-12 h.
  
  
  CONCLUSIONS
  The observed biphasic release of B-type natriuretic peptides supports standardization of sampling, taking recent exercise into account.
authors.affiliation: Department of Cardiology, Antwerp University Hospital, Belgium. Viviane.Conraads@uza.be
authors.forename: Viviane M A
authors.initials: VM
authors.lastname: Conraads
authors.forename: Cathérine
authors.initials: C
authors.lastname: De Maeyer
authors.forename: Paul
authors.initials: P
authors.lastname: Beckers
authors.forename: Nadine
authors.initials: N
authors.lastname: Possemiers
authors.forename: Manuella
authors.initials: M
authors.lastname: Martin
authors.forename: Viviane
authors.initials: V
authors.lastname: Van Hoof
authors.forename: Christiaan J
authors.initials: CJ
authors.lastname: Vrints
mesh_terms: D002908:Chronic Disease; D015444:Exercise; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010807:Physical Endurance; D055070:Resistance Training
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain