Giallauria Francesco, Lucci Rosa, De Lorenzo Anna, D'Agostino Mariantonietta, Del Forno Domenico, Vigorito Carlo
Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Cardiac Rehabilitation Unit, University of Naples Federico II, Naples, Italy.
Age Ageing. 2006 Nov;35(6):601-7. doi: 10.1093/ageing/afl098. Epub 2006 Sep 1.
regional or global impairment of left ventricular (LV) systolic or diastolic function leading to increased LV wall stress results in increased circulating levels of N-terminal pro-brain natriuretic peptide (NT-pro-BNP).
this study aims at evaluating the effect of exercise training (ET) on NT-pro-BNP plasma levels in older patients recovering from acute myocardial infarction (AMI).
prospective randomised study.
Academic Medical Centre.
forty older patients (33 males and 7 females) who experienced AMI.
patients were randomised into two groups, each composed of 20 patients: Group A were enrolled in a 3-month exercise-based cardiac rehabilitation (CR) programme and Group B were discharged home with generic instructions to continue physical activity. NT-pro-BNP, cardiopulmonary and Doppler-echocardiographic parameters were measured at baseline and at 3-month follow-up.
in Group A, ET reduced NT-pro-BNP levels (from 1446 +/- 475 to 435 +/- 251 pg/ml, P<0.001) and increased maximal exercise parameters; there was also an inverse correlation between changes in NT-pro-BNP levels and in VO(2peak) (r = -0.67, P<0.01), E-wave (r = -0.42, P<0.01) and E/A ratio (r = -0.60, P<0.01). In Group B, after 3 months, no changes were observed in NT-pro-BNP levels, exercise and echocardiographic parameters. LV volumes and left ventricular ejection fraction (LVEF) were unchanged after 3 months in both groups.
three months ET in older patients after AMI was associated with a reduction in NT-pro-BNP levels and an overall improvement of exercise capacity, without negative LV remodelling and with improvement in early LV filling. Further investigation is required to evaluate whether in these patients the reduction of NT-pro-BNP levels at 3 months could be useful as a surrogate marker of favourable LV remodelling at a later follow-up.
左心室（LV）收缩或舒张功能的局部或整体受损导致左心室壁应力增加，进而导致N末端脑钠肽前体（NT-pro-BNP）循环水平升高。
本研究旨在评估运动训练（ET）对急性心肌梗死（AMI）康复期老年患者血浆NT-pro-BNP水平的影响。
前瞻性随机研究。
学术医疗中心。
40例经历过AMI的老年患者（33例男性和7例女性）。
患者被随机分为两组，每组20例：A组参加为期3个月的基于运动的心脏康复（CR）计划，B组出院回家并给予继续体育活动的一般指导。在基线和3个月随访时测量NT-pro-BNP、心肺和多普勒超声心动图参数。
在A组中，ET降低了NT-pro-BNP水平（从1446±475降至435±251 pg/ml，P<0.001）并增加了最大运动参数；NT-pro-BNP水平变化与VO₂峰值（r = -0.67，P<0.01）、E波（r = -0.42，P<0.01）和E/A比值（r = -0.60，P<0.01）之间也存在负相关。在B组中，3个月后，NT-pro-BNP水平、运动和超声心动图参数均未观察到变化。两组3个月后左心室容积和左心室射血分数（LVEF）均未改变。
AMI后老年患者进行3个月的ET与NT-pro-BNP水平降低和运动能力整体改善相关，无左心室不良重塑且早期左心室充盈改善。需要进一步研究以评估这些患者3个月时NT-pro-BNP水平的降低是否可作为后期随访时左心室良好重塑的替代标志物。
