C-type natriuretic peptide expression in patients with chronic heart failure: effects of aerobic training.

Abstract

BACKGROUND:

C-type natriuretic peptide (CNP) is structurally related to cardiac natriuretic peptides and is currently considered as an endothelium-derived hyperpolarizing factor. Endothelial dysfunction, commonly observed in chronic heart failure (HF) patients is positively affected by physical training.

METHODS:

To evaluate the effect of aerobic physical training on the expression of CNP, 90 HF patients on optimal pharmacological treatment (age 62+/-2 years, mean+/-SEM), randomly assigned in a 3 : 1 ratio to either control group (C, 19 patients) or home-based aerobic exercise-training program group (T, 71 patients), completed the protocol. Plasma assay of CNP, brain natriuretic peptide or B-type natriuretic peptide (BNP), and norepinephrine; echocardiogram; and cardiopulmonary-stress test were performed in all patients at enrollment and after 9 months.

RESULTS:

At baseline, in both groups, CNP plasma level was significantly related to BNP (R=0.50), ejection fraction (R=0.43), and peak oxygen uptake (VO2, R=0.43, all P<0.001). After 9 months, trained patients showed an improvement in peak VO2 (P<0.001) and ejection fraction (P<0.05), whereas norepinephrine (P<0.05), BNP (P<0.001), and CNP (P<0.001) decreased. No changes occurred in group C. In group T, the decrease in CNP was significantly related to the increase in peak VO2 (R=0.31, P<0.01), and the relation between CNP and BNP was preserved at the end of the program (R=0.41, P<0.001).

CONCLUSION:

Clinical and functional improvement after physical training in HF patients is associated with a decrease in adrenergic activation and in both CNP and BNP concentration. Changes in CNP plasma concentration after physical training might reflect an improvement in endothelial function.

• Authors: Claudio Passino, Silvia Del Ry, Silvia Severino, Alessandra Gabutti, Concetta Prontera, Aldo Clerico, Daniela Giannessi, Michele Emdin
• Journal: European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology (Eur J Cardiovasc Prev Rehabil) Vol. 15 Issue 2 Pg. 168-72 (Apr 2008) ISSN: 1741-8267 [Print] England
• PMID: 18391643 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Biomarkers
• Cardiovascular Agents
• Natriuretic Peptide, Brain
• Natriuretic Peptide, C-Type
• Norepinephrine

Topics

• Biomarkers (blood)
• Cardiovascular Agents (therapeutic use)
• Chronic Disease
• Down-Regulation
• Echocardiography
• Exercise Test
• Exercise Therapy
• Female
• Heart Failure (blood, physiopathology, therapy)
• Humans
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Natriuretic Peptide, C-Type (blood)
• Norepinephrine (blood)
• Oxygen Consumption
• Prospective Studies
• Stroke Volume
• Time Factors
• Treatment Outcome
• Ventricular Function, Left