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European Journal of Heart Failure 2008 10(8):793-795; doi:10.1016/j.ejheart.2008.06.008
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© 2008 European Society of Cardiology

Exercise-induced biphasic increase in circulating NT-proBNP levels in patients with chronic heart failure

Viviane M.A. Conraadsa,*,1, Cathérine De Maeyera, Paul Beckersa, Nadine Possemiersa, Manuella Martinb, Viviane Van Hoofc and Christiaan J. Vrintsa

a Department of Cardiology, Antwerp University Hospital Belgium
b Laboratory of Hormones, Antwerp University Hospital Belgium
c Laboratory of Biochemistry, Antwerp University Hospital Belgium

* Corresponding author. Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium. Tel.: +32 3 821 46 72; fax: +32 3 821 39 74. E-mail address: Viviane.Conraads{at}uza.be (V.M.A. Conraads).


  Abstract

Background: Exercise increases natriuretic peptide levels in chronic heart failure (CHF) patients, but the effect is considered minor. We assessed acute and short-term release (<24 h) of NT-proBNP in CHF patients after a maximal cardiopulmonary exercise test (CPET) and 2 different submaximal training sessions.

Methods and results: 102 CHF patients either performed CPET (Group 1), a 1 h endurance (Group 2) or a combined endurance–resistance training session (Group 3). NT-proBNP concentration was determined before, at exercise cessation and after 18–22 h (Protocol A). In 20 patients, samples were obtained before, at exercise cessation, after 15, 30, 45, 60, 90 min, 2, 3, 4, 5, 6, 12, 22 h (Protocol B).

Protocol A: At peak exercise, a 15%, 11% and 17% relative increase (p<0.001 vs baseline, all 3 groups) was seen, with a return to baseline after 18–22 h. The increase correlated with indicators of more advanced heart failure.

Protocol B: A biphasic pattern was derived with a first peak within 1 h of exercise termination and a second peak (39%, 31% and 33% higher than baseline; p<0.05, all 3 groups) after 4–12 h.

Conclusions: The observed biphasic release of B-type natriuretic peptides supports standardization of sampling, taking recent exercise into account.

Key Words: Natriuretic peptides • Chronic heart failure • Exercise

Received April 1, 2008; Revised May 21, 2008; Accepted June 10, 2008

1 Viviane Conraads is a Senior Clinical Investigator of the Fund for Scientific Research (FWO)-Flanders (Belgium).


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