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J Am Coll Cardiol. 2006 May 2;47(9):1835-9. Epub 2006 Apr 19.

Aerobic training decreases B-type natriuretic peptide expression and adrenergic activation in patients with heart failure.

Author information

1
Cardiovascular Medicine Department, CNR Institute of Clinical Physiology, Pisa, Italy. passino@ifc.cnr.it

Abstract

OBJECTIVES:

We sought to evaluate the effect of physical training on neurohormonal activation in patients with heart failure (HF).

BACKGROUND:

Patients with HF benefit from physical training. Chronic neurohormonal activation has detrimental effects on ventricular remodeling and prognosis of patients with HF.

METHODS:

A total of 95 patients with HF were assigned randomly into two groups: 47 patients (group T) underwent a nine-month training program at 60% of the maximal oxygen uptake (VO2), whereas 48 patients did not (group C). The exercise load was adjusted during follow-up to achieve a progressive training effect. Plasma assay of B-type natriuretic peptide (BNP), amino-terminal pro-brain natriuretic peptide (NT-proBNP), norepinephrine, plasma renin activity, and aldosterone; quality-of-life questionnaire; echocardiogram; and cardiopulmonary stress test were performed upon enrollment and at the third and ninth month.

RESULTS:

A total of 85 patients completed the protocol (44 in group T, left ventricular ejection fraction [EF] 35 +/- 2%, mean +/- SEM; and 41 in group C, EF 32 +/- 2%, p = NS). At the ninth month, patients who underwent training showed an improvement in workload (+14%, p < 0.001), peak VO2 (+13%, p < 0.001), systolic function (EF +9%, p < 0.01), and quality of life. We noted that BNP, NT-proBNP, and norepinephrine values decreased after training (-34%, p < 0.01; -32%, p < 0.05; -26%, p < 0.01, respectively). Increase in peak VO2 with training correlated significantly with the decrease in both BNP/NT-proBNP level (p < 0.001 and p < 0.01, respectively). Patients who did not undergo training showed no changes.

CONCLUSIONS:

Clinical benefits after physical training in patients with HF are associated with blunting of adrenergic overactivity and of natriuretic peptide overexpression.

PMID:
16682309
DOI:
10.1016/j.jacc.2005.12.050
[Indexed for MEDLINE]
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