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[Relationship between exercise capacity and brain natriuretic peptide in patients after cardiac surgery]
Yoshihiro J Akashi1, Akira Koike, Kazuto Omiya
1Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Sugao 2-16-1, Miyamae-ku, Kawasaki 216-8511.
Insights
Physical training improves exercise capacity and reduces brain natriuretic peptide (BNP) in cardiac surgery patients. These benefits were observed in both coronary artery bypass grafting and valve replacement groups after six months of rehabilitation.
Area of Science:
- Cardiology
- Exercise Physiology
- Biomarkers
Context:
- Cardiac rehabilitation programs are crucial for patients post-cardiac surgery.
- Exercise capacity and biomarkers like brain natriuretic peptide (BNP) are key indicators of cardiac health.
- The impact of physical training on these parameters may vary based on the underlying cardiac condition.
Purpose:
- To investigate the effects of a 6-month physical training program on exercise capacity and plasma BNP levels.
- To compare these effects in patients who underwent coronary artery bypass grafting (CABG) versus valve replacement (VR).
Summary:
- Ninety-one CABG and 78 VR patients completed a 6-month exercise program, with cardiopulmonary exercise tests and BNP measurements before and after training.
- Both groups showed significant improvements in anaerobic threshold and peak oxygen uptake (peak-Vo2).
- BNP levels decreased significantly in the VR group and showed a trend toward decrease in the CABG group. Peak-Vo2 correlated negatively with BNP in both groups post-training.
Impact:
- Six months of physical training can enhance functional capacity and reduce BNP in post-cardiac surgery patients.
- This study highlights the benefits of structured exercise in cardiac recovery.
- Findings suggest that BNP may serve as a useful biomarker for monitoring training response in these patient populations.
Objectives:
Physical training in cardiac patients can increase exercise capacity and reduce plasma brain natriuretic peptide(BNP) concentration, but these effects may depend on the etiology of cardiac disease. The change in exercise capacity and BNP during the training period were investigated in patients with different cardiac diseases.
Methods:
Ninety-one patients after coronary artery bypass grafting(CABG) and 78 patients after valve replacement (VR) underwent a symptom-limited incremental cardiopulmonary exercise test before (1 month) and 6 months after physical training. Anaerobic threshold and peak oxygen uptake(peak-Vo2) were measured during the cardiopulmonary exercise test. Before each cardiopulmonary exercise test, a blood sample was obtained in the resting condition for measuring BNP.
Results:
Anaerobic threshold and peak-Vo2 were increased significantly from 1 month to 6 months in both groups. BNP in the CABG group indicated a tendency to decrease (194.6 +/- 155.3-->144.2 +/- 232.2 pg/ml, p < 0.1) from 1 month to 6 months. BNP in VR group was significantly decreased (159. 9 +/- 115.5-->112.8 +/- 131.7 pg/ml, p < 0.05) during the training period. The CABG group showed a significant negative correlation between peak-Vo2 and BNP at 1 month(r = -0.28, p < 0.01) and at 6 months(r = -0.39, p = 0.001). The VR group showed a significant negative correlation between peak-Vo2 and BNP at 6 months(r = -0.32, p < 0.01), but not at 1 month.
Conclusions:
Six months of physical training in patients after cardiac surgery may improve exercise capacity and reduce BNP. BNP concentration in the VR group before physical training did not reflect functional capacity.