Exercise-induced biphasic increase in circulating NT-proBNP levels in patients with chronic heart failure.
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.
Conraads
Viviane M A
VM
Department of Cardiology, Antwerp University Hospital, Belgium. Viviane.Conraads@uza.be
De Maeyer
Cathérine
C
Beckers
Paul
P
Possemiers
Nadine
N
Martin
Manuella
M
Van Hoof
Viviane
V
Vrints
Christiaan J
CJ
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
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain