Congestive Heart FailureStability of B-type natriuretic peptide levels during exercise in patients with congestive heart failure: Implications for outpatient monitoring with B-type natriuretic peptide*,**
Section snippets
Study population
This study was approved by University of California Institutional Review Board. Twenty subjects with CHF observed at the San Diego Veterans Affairs Healthcare Systems Cardiomyopathy Clinic were enrolled in the study based on their symptoms according to the New York Heart Association (NYHA) classification. A total of 10 subjects with NYHA class I or II CHF and 10 subjects with NYHA class III or IV CHF were enrolled. Ten control subjects were selected who had no CHF or other cardiac or pulmonary
Results
Patient characteristics are reported in Table I. The mean BNP value of the NYHA III-IV group was significantly higher than the mean BNP value of the NYHA I-II group (P <.001), which in turn, was significantly higher than the mean of the no CHF group (P <.001). In contrast, there were no significant differences in epinephrine (P =.89) or norepinephrine (P =.22) levels among the groups. The scope of exercise as a function of both the maximum predicted heart rate and maximum Borg scale was similar
Discussion
Although major advances in our understanding of the pathophysiologic condition of CHF have resulted in treatments that lead to symptomatic improvement and longer life, CHF remains a major clinical challenge. Not only do we have difficulty making the diagnosis of heart failure, we have an even greater challenge in assessing the results of treatment, both in the hospital and the outpatient setting. The fact that the direct costs of heart failure exceed $38 billion, greater than 5% of total health
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Acute Responses to Intermittent and Continuous Exercise in Heart Failure Patients
2013, Canadian Journal of CardiologyCitation Excerpt :Furthermore, BNP, an important biomarker of ventricular mechanical stress and prognosis in relation to the severity of ventricular dysfunction,31 did not increase after HIIE or MICE. These results are consistent with previous data showing the lack of effect of a single maximal exercise on BNP.32-34 Finally, with respect to CRP, conflicting data exist on the impact of exercise on this biomarker.
The interface of hypothalamic-pituitary-adrenocortical axis and circulating brain natriuretic peptide in prediction of cardiopulmonary performance during physical stress
2013, PeptidesCitation Excerpt :However, the literature data about the dynamics of NT-pro-BNP during physical stress are controversial. Some studies showed that there are no significant changes of this hormone during physical stress [91,94], while others showed an increase in plasma levels [29,46,53,62], not only during dynamic but also during static load [16], which is in accordance with our results. The increase of NT-pro-BNP can be explained by the fact that exercise might generate transitory ischemia, increase of wall stress and diastolic dysfunction [6], which are stimuli for the NT-pro-BNP secretion [36,47], in order to obtain further necessary regulation of cardiac function in stress condition.
Natriuretic Peptides: Physiologic and Analytic Considerations
2009, Heart Failure ClinicsCould B-type Natriuretic Peptide (BNP) plasma concentration be useful to predict fluid in critically ill patients with acute circulatory failure?
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This study was supported in part by an unrestricted grant from Biosite Diagnostics, San Diego, Calif.
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Reprint requests: Alan Maisel, MD, VAMC Cardiology 111-A, 3350 La Jolla Village Drive, San Diego, CA 92161.E-mail: [email protected].