Journal of Applied Physiology
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J Appl Physiol 85: 2270-2276, 1998;
8750-7587/98 $5.00
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Vol. 85, Issue 6, 2270-2276, December 1998

Enhanced brain natriuretic peptide response to peak exercise in heart transplant recipients

Bernard Geny1,2, Anne Charloux1, Eliane Lampert1, Jean Lonsdorfer1, Pascal Haberey2, and François Piquard1,2

1 Laboratoire des Régulations Physiologiques et des Rythmes Biologiques chez l'Homme, Faculté de Médecine, Institut de Physiologie, and 2 Service d'Explorations Fonctionnelles Cardiocirculatoires, Faculté de Médecine, F-67085 Strasbourg Cedex, France

We investigated the atrial (ANP) and brain natriuretic peptides (BNP), catecholamines, heart rate, and blood pressure responses to graded upright maximal cycling exercise of eight matched healthy subjects and cardiac-denervated heart transplant recipients (HTR). Baseline heart rate and diastolic blood pressure, together with ANP (15.2 ± 3.7 vs. 4.4 ± 0.8 pmol/l; P < 0.01) and BNP (14.3 ± 2.6 vs. 7.4 ± 0.6 pmol/l; P < 0.01), were elevated in HTR, but catecholamine levels were similar in both groups. Peak exercise O2 uptake and heart rate were lower in HTR. Exercise-induced maximal ANP increase was similar in both groups (167 ± 34 vs. 216 ± 47%). Enhanced BNP increase was significant only in HTR (37 ± 8 vs. 16 ± 8%; P < 0.05). Similar norepinephrine but lower peak epinephrine levels were observed in HTR. ANP and heart rate changes from rest to 75% peak exercise were negatively correlated (r = -0.76, P < 0.05), and BNP increase was correlated with left ventricular mass index (r = 0.83, P < 0.01) after heart transplantation. Although ANP increase was not exaggerated, these data support the idea that the chronotropic limitation secondary to sinus node denervation might stimulate ANP release during early exercise in HTR. Furthermore, the BNP response to maximal exercise, which is related to the left ventricular mass index of HTR, is enhanced after heart transplantation.

catecholamines; echocardiographic data; hemodynamics; oxygen uptake


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