Urine microalbumin excretion in relation to exercise-induced electrocardiographic myocardial ischaemia

Microalbuminuria, a marker of endothelial cell dysfunction, is associated with atherosclerosis and is a predictor of coronary heart disease. It has been suggested that patients with coronary heart disease have exaggerated exercise-induced urinary microalbumin excretion but this is controversial. We, therefore, measured urine microalbumin excretion in men before and after an exercise electrocardiogram.

Urine microalbumin excretion expressed as the albumin-creatinine ratio (ACR) was measured before and after an exercise electrocardiogram in 10 subjects with exercise-induced myocardial ischaemia and 14 subjects without exercise-induced myocardial ischaemia.

In subjects with a positive exercise electrocardiogram, the pre-exercise electrocardiogram ACR 3.3 +/- 5.50; (mean+/-SD) significantly increased (p=0.0371) following exercise (6.30 +/-10.25). In subjects with a negative exercise electrocardiogram, the pre-exercise electrocardiogram ACR (0.73 +/-0.52) also significantly increased (p=0.0295) following exercise (2.04 +/-1.81). Pre-exercise ACR was higher (p=0.0164) in subjects with a positive exercise electrocardiogram (3.3 +/-5.50) than in those subjects with a negative exercise electrocardiogram (0.73 +/-0.52). Incremental and post-exercise ACR were not significantly different in those with normal and abnormal exercise electrocardiograms.

Patients with exercise-induced myocardial ischaemia have pre-exercise urine microalbumin excretion. Exaggerated urine microalbumin excretion in response to exercise is not associated with exercise-induced myocardial ischaemia.