Plasma B-type natriuretic peptide levels are poorly related to the occurrence of ischemia or ventricular arrhythmias during symptom-limited exercise in low-risk patients
Porta, Andreu (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Barrabés, José A.. (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Candell-Riera, Jaume (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Agulló, Luis (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Aguadé-Bruix, Santiago (Hospital Universitari Vall d'Hebron. Institut de Recerca)
de León, Gustavo (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Figueras Bellot, Jaume (Hospital Universitari Vall d'Hebron. Institut de Recerca)
García-Dorado, David (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Fecha:	2016
Resumen:	The usefulness of B-type natriuretic peptide (BNP) as a marker of ischemia is controversial. BNP levels have predicted arrhythmias in various settings, but it is unknown whether they are related to exercise-induced ischemic ventricular arrhythmias. We analyzed in 63 patients (64 ±14 years, 65% male, 62% with known coronary disease) undergoing exercise stress single-photon emission computed tomography (SPECT) the association between plasma BNP values (before and 15 min after exercise) and the occurrence of ischemia or ventricular arrhythmias during the test. Exercise test (8. 1 ±2. 7 min, 7. 4 ±8. 1 metabolic equivalents, 82 ±12% of maximal predicted heart rate) induced reversible perfusion defects in 23 (36%) patients. Eight (13%) patients presented significant arrhythmias (≥ 7 ventricular premature complexes/min, couplets, or non-sustained ventricular tachycardia during exercise or in the first minute of recovery). Median baseline BNP levels were 17. 5 (12. 4-66. 4) pg/ml in patients developing scintigraphic ischemia and 45. 6 (13. 2-107. 4) pg/ml in those without ischemia (p = 0. 137). The BNP levels increased after exercise (34. 4 (15. 3-65. 4)% increment over baseline, p < 0. 001), but the magnitude of this increase was not related to SPECT positivity (35. 7 (18. 8-65. 4)% vs. 27. 9 (5. 6-64. 0)% in patients with and without ischemia, respectively, p = 0. 304). No significant association was found between BNP values (at baseline or their change during the test) and ventricular arrhythmias. Plasma BNP values - at baseline or after exercise - were not associated with myocardial ischemia or with ventricular arrhythmia during exercise SPECT. These results highlight the limited usefulness of this biomarker to assess acute ischemia.
Ayudas:	Instituto de Salud Carlos III FIS PI12-01844
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra, i la creació d'obres derivades, sempre que no sigui amb finalitats comercials i que es distribueixin sota la mateixa llicència que regula l'obra original. Cal que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Biomarkers ; Exercise stress test ; Ischemia ; Natriuretic peptides
Publicado en:	Archives of Medical Science : AMS, Vol. 12 (april 2016) , p. 341-348, ISSN 1896-9151

DOI: 10.5114/aoms.2016.59258
PMID: 27186178

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