Exertional Changes in Circulating Cardiac Natriuretic Peptides in Patients with Suggested Coronary Artery Disease

Sébastien Bergeron, Jacob E. Møller, Kent R Bailey, Horng Haur Chen, John C Jr. Burnett, Patricia Pellikka

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12 Citations (Scopus)

Abstract

Background: We measured plasma brain natriuretic peptide (BNP) and N-terminal atrial natriuretic peptide (ANP) levels before and after exercise stress testing and correlated results with echocardiographic evidence of ischemia. Methods: Sixty patients with left ventricular ejection fraction greater than 50% referred for clinically indicated exercise echocardiogram were studied. Peptides were measured at rest and 5 minutes after symptom-limited exercise. Results: Echocardiography was positive for ischemia in 19 (32%). With exercise, ANP level increased in all 60 patients (median at rest 2501 [799-6440]-3167 [977-8563] pg/mL after exercise [P < .0001]). BNP increased in 54 patients (90%) (19 [<3.9-213]-30 [<3.9-318] pg/mL [P < .0001]). In multivariable analysis, both exercise BNP level and exertional change in BNP were closely associated with rest BNP (P < .0001); both were also significantly associated with change in wall-motion score index and workload (P = .001 and P = .01, respectively). Exercise ANP was strongly related to rest level (P < .0001); change in ANP was related to workload (P < .0001). Conclusion: In patients with suggested coronary artery disease, exertional levels of BNP are influenced not only by development of stress-induced ischemia, but also by resting levels.

Original languageEnglish (US)
Pages (from-to)772-776
Number of pages5
JournalJournal of the American Society of Echocardiography
Volume19
Issue number6
DOIs
StatePublished - Jun 2006

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Natriuretic Peptides
Brain Natriuretic Peptide
Coronary Artery Disease
Exercise
Atrial Natriuretic Factor
Ischemia
Workload
Stroke Volume
Echocardiography
Peptides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

@article{10147a0d508d49fab50c58bd21ab5892,
title = "Exertional Changes in Circulating Cardiac Natriuretic Peptides in Patients with Suggested Coronary Artery Disease",
abstract = "Background: We measured plasma brain natriuretic peptide (BNP) and N-terminal atrial natriuretic peptide (ANP) levels before and after exercise stress testing and correlated results with echocardiographic evidence of ischemia. Methods: Sixty patients with left ventricular ejection fraction greater than 50{\%} referred for clinically indicated exercise echocardiogram were studied. Peptides were measured at rest and 5 minutes after symptom-limited exercise. Results: Echocardiography was positive for ischemia in 19 (32{\%}). With exercise, ANP level increased in all 60 patients (median at rest 2501 [799-6440]-3167 [977-8563] pg/mL after exercise [P < .0001]). BNP increased in 54 patients (90{\%}) (19 [<3.9-213]-30 [<3.9-318] pg/mL [P < .0001]). In multivariable analysis, both exercise BNP level and exertional change in BNP were closely associated with rest BNP (P < .0001); both were also significantly associated with change in wall-motion score index and workload (P = .001 and P = .01, respectively). Exercise ANP was strongly related to rest level (P < .0001); change in ANP was related to workload (P < .0001). Conclusion: In patients with suggested coronary artery disease, exertional levels of BNP are influenced not only by development of stress-induced ischemia, but also by resting levels.",
author = "S{\'e}bastien Bergeron and M{\o}ller, {Jacob E.} and Bailey, {Kent R} and Chen, {Horng Haur} and Burnett, {John C Jr.} and Patricia Pellikka",
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T1 - Exertional Changes in Circulating Cardiac Natriuretic Peptides in Patients with Suggested Coronary Artery Disease

AU - Bergeron, Sébastien

AU - Møller, Jacob E.

AU - Bailey, Kent R

AU - Chen, Horng Haur

AU - Burnett, John C Jr.

AU - Pellikka, Patricia

PY - 2006/6

Y1 - 2006/6

N2 - Background: We measured plasma brain natriuretic peptide (BNP) and N-terminal atrial natriuretic peptide (ANP) levels before and after exercise stress testing and correlated results with echocardiographic evidence of ischemia. Methods: Sixty patients with left ventricular ejection fraction greater than 50% referred for clinically indicated exercise echocardiogram were studied. Peptides were measured at rest and 5 minutes after symptom-limited exercise. Results: Echocardiography was positive for ischemia in 19 (32%). With exercise, ANP level increased in all 60 patients (median at rest 2501 [799-6440]-3167 [977-8563] pg/mL after exercise [P < .0001]). BNP increased in 54 patients (90%) (19 [<3.9-213]-30 [<3.9-318] pg/mL [P < .0001]). In multivariable analysis, both exercise BNP level and exertional change in BNP were closely associated with rest BNP (P < .0001); both were also significantly associated with change in wall-motion score index and workload (P = .001 and P = .01, respectively). Exercise ANP was strongly related to rest level (P < .0001); change in ANP was related to workload (P < .0001). Conclusion: In patients with suggested coronary artery disease, exertional levels of BNP are influenced not only by development of stress-induced ischemia, but also by resting levels.

AB - Background: We measured plasma brain natriuretic peptide (BNP) and N-terminal atrial natriuretic peptide (ANP) levels before and after exercise stress testing and correlated results with echocardiographic evidence of ischemia. Methods: Sixty patients with left ventricular ejection fraction greater than 50% referred for clinically indicated exercise echocardiogram were studied. Peptides were measured at rest and 5 minutes after symptom-limited exercise. Results: Echocardiography was positive for ischemia in 19 (32%). With exercise, ANP level increased in all 60 patients (median at rest 2501 [799-6440]-3167 [977-8563] pg/mL after exercise [P < .0001]). BNP increased in 54 patients (90%) (19 [<3.9-213]-30 [<3.9-318] pg/mL [P < .0001]). In multivariable analysis, both exercise BNP level and exertional change in BNP were closely associated with rest BNP (P < .0001); both were also significantly associated with change in wall-motion score index and workload (P = .001 and P = .01, respectively). Exercise ANP was strongly related to rest level (P < .0001); change in ANP was related to workload (P < .0001). Conclusion: In patients with suggested coronary artery disease, exertional levels of BNP are influenced not only by development of stress-induced ischemia, but also by resting levels.

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