Berent Robert, von Duvillard Serge P, Crouse Stephen F, Auer Johann, Green John S, Sinzinger Helmut, Schmid Peter
Center for Cardiovascular Rehabilitation, Rehabilitationszentrum Austria, Stifterstrasse 11, Bad Schallerbach 4701, Austria.
Eur J Cardiovasc Prev Rehabil. 2009 Oct;16(5):603-8. doi: 10.1097/HJR.0b013e32832d7ca8.
The inactive N-terminal pro-BNP (NT-proBNP) serves as a marker of heart failure. We evaluated the effects of moderate exercise on NT-proBNP and other cardiovascular disease risk factors in 359 consecutive patients admitted for residential cardiovascular rehabilitation.
Patients underwent cycle ergometry, blood sampling, and fasting glucose tests at the beginning and end of 25+/-4 days of the exercise program. Maximal oxygen uptake (VO2max) was estimated from the maximal watts achieved. The program consisted of cycling for 17+/-4 min, 6 times/week, and daily walking for 45 min at intensity of 60-70% of the individual maximal heart rate (HR). Patients underwent echocardiographic examination and were categorized according to left ventricular ejection fraction. NT-proBNP decreased to 29% (P = 0.001) for entire group after training. Maximal performance and VO2max improved significantly (P = 0.001). NT-proBNP was inversely related to pulse pressure at maximal exercise (-0.39), HR range (-0.35), and HR recovery in 1 min (-0.28).
Four weeks of exercise reduced NT-proBNP, independent of left ventricular ejection fraction, and improved physical fitness and blood lipid profiles. NT-proBNP as a prognostic biomarker of heart failure patients was reduced and was inversely related to maximal performance and VO2max.
无活性的N末端脑钠肽前体(NT-proBNP)是心力衰竭的标志物。我们评估了适度运动对359例连续入住进行心血管康复治疗患者的NT-proBNP及其他心血管疾病危险因素的影响。
患者在运动计划开始和结束时(25±4天)进行了蹬车运动测试、血液采样及空腹血糖检测。根据达到的最大功率估算最大摄氧量(VO2max)。该计划包括每周6次、每次17±4分钟的骑车运动,以及每天以个人最大心率(HR)的60%-70%强度步行45分钟。患者接受了超声心动图检查,并根据左心室射血分数进行分类。训练后,整个组的NT-proBNP下降了29%(P = 0.001)。最大运动能力和VO2max显著改善(P = 0.001)。NT-proBNP与最大运动时的脉压(-0.39)、心率范围(-0.35)及1分钟内心率恢复情况(-0.28)呈负相关。
四周的运动降低了NT-proBNP,与左心室射血分数无关,并改善了体能和血脂状况。作为心力衰竭患者预后生物标志物的NT-proBNP降低了,且与最大运动能力和VO2max呈负相关。