Reduction of N terminal-pro-brain (B-type) natriuretic peptide levels with exercise-based cardiac rehabilitation in patients with left ventricular dysfunction after myocardial infarction
Abstract
INTRODUCTION: N-terminal-pro-brain (B-type) natriuretic peptide (NT-pro-BNP) is a peptide hormone released from ventricles in response to myocyte stretch. The aim of the study was to investigate the influence of exercise training on plasma NT-pro-BNP to verify if this parameter could be used as a biological marker of left ventricular remodelling in myocardial infarction patients undergoing an exercise training programme. METHODS: Forty-four patients after myocardial infarction were enrolled into a cardiac rehabilitation programme, and were randomized in two groups of 22 patients each. Group A patients followed a 3-month exercise training programme, while group B patients received only routine recommendations. All patients underwent NT-pro-BNP assay, and cardiopulmonary exercise test before hospital discharge and after 3 months. RESULTS: In Group A, exercise training reduced NT-pro-BNP levels (from 1498+/-438 to 470+/-375 pg/ml, P=0.0026), increased maximal (VO2peak+4.3+/-2.9 ml/kg per min, P<0.001; Powermax+38+/-7, P<0.001) exercise parameters and work efficiency (Powermax/VO2peak+1.3+/-0.4 Power/ml per kg per min, P<0.001); there was also an inverse correlation between changes in NT-pro-BNP levels and in VO2peak (r=-0.72, P<0.001), E-wave (r=-0.51, P<0.001) and E/A ratio (r=0.59, P<0.001). In group B, at 3 months, no changes were observed in NT-pro-BNP levels, exercise and echocardiographic parameters. CONCLUSION: Three months exercise training in patients with moderate left ventricular systolic dysfunction after myocardial infarction induced a reduction in NT-pro-BNP levels, an improvement of exercise capacity and early left ventricular diastolic filling, without negative left ventricular remodelling. Whether the reduction of NT-pro-BNP levels could be useful as a surrogate marker of favourable left ventricular remodelling at a later follow-up remains to be further explored.
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Exercise-mediated improvement in myocardial regenerative capacity after MI is mediated by reductions in wall stress together with increases in early LV diastolic filling in the context of improved LV remodelling (as reflected by lower NT-proBNP levels).
“reductions in wall stress together with increases in early LV diastolic filling in the context of an improved LV remodelling (as reflected by lower NT-proBNP levels); 164”
From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [164]
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Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation
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Self-citation
- Authors
- Giallauria, F., Lorenzo, A. D., Pilerci, F., Manakos, A., Lucci, R., Psaroudaki, M., D'Agostino, M., Forno, D. D., & Vigorito, C.
- Affiliations
- University of Naples Federico II (IT)
- Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University of Naples Federico II, Naples, Italy.
- Corresponding author
- Giallauria, Francesco
- Venue
- European Journal of Cardiovascular Prevention & Rehabilitation
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-08
- Volume
- 13
- Issue
- 4
- Pages
- 625-632
- ISSN
- 1741-8267 (ISSN-L)
- OpenAlex
- W2131374424
- Cited by
- 60
- References
- 36
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 2 · 2020: 5 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 1 · 2015: 6 · 2014: 4 · 2013: 5 · 2012: 5
- FWCI
- 7.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Cardiovascular Prevention & Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- NT-proBNP, exercise training, cardiac rehabilitation, myocardial infarction, left ventricular dysfunction, left ventricular remodeling, exercise capacity, diastolic filling, biomarkers, cardiopulmonary exercise testing
- MeSH terms
- Exercise Therapy, Female, Heart Ventricles, Humans, Male, Middle Aged, Myocardial Contraction, Myocardial Infarction, Biomarkers, Exercise, Treatment Outcome, Ventricular Dysfunction, Left, Echocardiography, Doppler, Pulsed, Natriuretic Peptide, Brain
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