title: Endurance exercise-induced changes in BNP concentrations in cardiovascular patients versus healthy controls.
abstract: BACKGROUND
  Healthy athletes demonstrated increased B-type natriuretic peptide (BNP) concentrations following exercise, but it is unknown whether these responses are exaggerated in individuals with cardiovascular risk factors (CVRF) or disease (CVD). We compared exercise-induced increases in BNP between healthy controls (CON) and individuals with CVRF or CVD. Furthermore, we aimed to identify predictors for BNP responses.
  
  
  METHODS
  Serum BNP concentrations were measured in 191 participants (60±12yrs) of the Nijmegen Marches before (baseline) and immediately after 4 consecutive days of walking exercise (30-50km/day). CVRF (n=54) was defined as hypertension, hypercholesterolemia, obesity or smoking and CVD (n=55) was defined as a history of myocardial infarction, heart failure, atrial fibrillation or angina pectoris.
  
  
  RESULTS
  Individuals walked 487±79min/day at 65±10% of their maximum heart rate. Baseline BNP concentrations were higher for CVD (median: 28.1pg/ml; interquartile range: 13-50, p<0.001) compared to CVRF (3.9pg/ml; 0-14) and CON (5.5pg/ml; 0-14). Post-exercise BNP concentrations were elevated in CVD (35.7pg/ml, 17-67, p=0.01), but not in CVRF participants (p=0.11) or CON (p=0.07). No cumulative effect in BNP concentrations was observed across the consecutive walking days (p>0.05). Predictors for post-exercise BNP (R2=0.77) were baseline BNP, beta-blocker use and age.
  
  
  CONCLUSIONS
  Prolonged moderate-intensity walking exercise increases BNP concentrations in CVD participants, but not in CVRF and CON. BNP increases were small, and did not accumulate across consecutive days of exercise. These findings suggest that prolonged walking exercise for multiple consecutive days is feasible with minimal effect on myocardial stretch, even for participants with CVD.
authors.affiliation: Radboud Institute of Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud Institute of Health Sciences, Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Aengevaeren
authors.affiliation: Radboud Institute of Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Maria T E
authors.initials: MTE
authors.lastname: Hopman
authors.affiliation: Radboud Institute of Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK.
authors.forename: Dick H J
authors.initials: DHJ
authors.lastname: Thijssen
authors.affiliation: Radboud Institute of Health Sciences, Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Roland R
authors.initials: RR
authors.lastname: van Kimmenade
authors.affiliation: Radboud Institute of Health Sciences, Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Menko-Jan
authors.initials: MJ
authors.lastname: de Boer
authors.affiliation: Radboud Institute of Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK. Electronic address: Thijs.Eijsvogels@radboudumc.nl.
authors.forename: Thijs M H
authors.initials: TMH
authors.lastname: Eijsvogels
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood*; D016022:Case-Control Studies; D015331:Cohort Studies; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012146:Rest; D012307:Risk Factors; D013997:Time Factors; D016138:Walking / Q000502:physiology*
chemical_list: D020097:Natriuretic Peptide, Brain
keywords: Biomarkers; Cardiovascular diseases; Risk factors; Walking