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

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

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

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 1 2006

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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