EFFECT OF ENDURANCE EXERCISE ON BRAIN NATRIURETIC PEPTIDE (BNP)

Main Article Content

Hafeezullah Wazir Ali
Muhammad Aslam
Sohail Aziz
Muhammad Mazhar Hussain
Farmanullah Wazir

Abstract

OBJECTIVE: To evaluate the effect of maximal exercise on the level ofbrain natriuretic peptide (BNP) and cardiac adaptive changes in endurancetrained elite athletes and sedentary healthy subjects.

METHODOLOGY: This Cross-sectional comparative study was conductedat Army Medical College in collaboration with Armed ForcesInstitute of Cardiology (AFIC) Rawalpindi. Twenty two elite enduranceathletes (Long Distance Runners) and 22 matching sedentary (from sameunit having no sports activity) controls were selected by convenience(non-probability) sampling technique. Height, body weight, blood pressure,pulse rate and ECG were recorded. The blood was drawn fromantecubital vein for measuring BNP and aldosterone before exerciseand again after exercise. The echocardiography of left ventricle wasdone to measure the end-diastolic internal diameter (LVIDd), diastolicinterventricular septal thickness (IVSTd), and diastolic posterior wallthickness (PWTd). The left ventricular mass (LVM) was calculated byDevereux formula. The data were recorded in a proforma and analyzedby SPSS version 10.

RESULTS: It was observed that the heart rate and blood pressure ofathletes were significantly less than the controls (p<0.001); while LVIDd,IVST, PWTd, and LVM was greater in athletes than controls (p<0.001).Pre-exercise BNP level was 45.29+18.69 pmol/l & 34.16+13.74 pmol/lwhile post-exercise BNP level was 58.32+19.65 pmol/l & 43.638+11.82pmol/l in athletes and controls respectively (p<0.01). Pre-exerciseAldosterone level was 15.34+2.77 ng/dl & 13.05+2.134 ng/dl whilepost-exercise BNP level was 16.01+2.14 ng/dl & 14.65+2.30 ng/dl inathletes and controls respectively (p<0.01).

CONCLUSION: The maximal exercise increases the level of BNP inelite athletes significantly.

Article Details

How to Cite
Ali, H. W., M. Aslam, S. Aziz, M. M. Hussain, and F. Wazir. “EFFECT OF ENDURANCE EXERCISE ON BRAIN NATRIURETIC PEPTIDE (BNP)”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 5, no. 2, June 2013, https://www.kmuj.kmu.edu.pk/article/view/66-70.
Section
Original Articles
Author Biography

Hafeezullah Wazir Ali, Northern Border University

Associate Professor, Department of Physiology, Northern Border University, Arar, Saudi Arabia

References

Abernethy WB, Choo JK, Hutter AM

Jr. Echocardiographic characteristics of

professional football players. J Am Coll

Cardiol 2003; 41: 280-4.

Urhausen A, Kindermann W. Sports-specific

adaptations and differentiation of

the athlete’s heart. Sports Med 1999;

: 237-44.

Scharhag J, Schneider G, Urhausen A,

RochetteV, Kramann B, Kindermann W.

Athlete’s heart: Right and left ventricular

mass and function in male endurance athletes

and untrained individuals determined

by magnetic resonance imaging. J Am Coll

Cardiol 2002; 40: 1856-63.

Bordbar S, Bigi MA, Aslani A, Rahimi E, Ahmadi

N. Effect of endurance and strength

exercise on release of brain natriuretic

peptide. J Cardiovasc Dis Res 2012; 3(1):22-5. doi: 10.4103/0975-3583.91599.

Clerico A, Iervasi G, Mariani G. Pathophysiologic

relevance of measuring the plasma

levels of cardiac natriuretic peptide hormones

in humans [Review]. Horm Metab

Res 1999; 31: 487-98.

Kangawa H, Marsuo H. Purification and

complete amino acid sequence of alpha

human atrial natriuretic polypeptide

(alpha-h ANP). Biochem Biophys Res

Commun 1984; 118: 131-9.

Sudoh T, Kangawa K, Minamino N, Matsuo

H. A new natriuretic peptide in porcine

brain. Nature 1988; 332: 78-81.

Conraads VM, De Maeyer C, Beckers P,

Possemiers N, Martin M, Van Hoof V, et

al. Exercise-induced biphasic increase in

circulating NT-proBNP levels in patients

with chronic heart failure. Eur J Heart Fail

; 10(8): 793-5.

Mukoyama M, Nakao K, Hosoda K. Brain

natriuretic peptide as a novel cardiac hormone

in humans: evidence for an exquisite

dual natriuretic peptide system, atrial

natriuretic peptide and brain natriuretic

peptide. J Clin Invest 1991; 87: 1402-12.

Maria Sarullo F, Gristina T, Brusca I, Milia

S, Raimondi R, Sajeva M, et al. Effect of

physical training on exercise capacity,

gas exchange and N-terminal pro-brain

natriuretic peptide levels in patients with

chronic heart failure. Eur J Cardiovasc Prev

Rehabil. 2006; 13(5): 812-7.

Nie J, George KP, Tong TK, Tian Y, Shi

Q. Effect of repeated endurance runs

on cardiac biomarkers and function in

adolescents. Med Sci Sports Exerc 2011;

(11): 2081-8.

Mark DB, Felker GM. B-Type Natriuretic

Peptide - A Biomarker for All Seasons? N

Eng J Med 2004; 350 (7): 718-20.

Tsekoura DK, Karavidas AI, Raisakis KG,

Zacharoulis AZ. Brain Natriuretic Peptide.

Hellenic J Cardio 2003; 44: 266-70.

D’Andrea A, Limongelli G, Caso P, Sarubbi

B, Della Pietra A, Brancaccio P, et al. Association

between left ventricular structure

and cardiac performance during effort

in two morphological forms of athlete’s

heart. Int J Cardiol 2002; 86(2-3): 177-84.

Pela G, Bruschi G, Montagna L, Manara

M, Manca C. Left and right ventricular

adaptation assessed by Doppler tissue

echocardiography in athletes. J Am Soc

Echocardiogr 2004; 17: 205-11.

Date H, Imamura T, Onitsuka H, Maeno M,

Watanabe R, Nishihira K, et al. Differential

increase in natriuretic peptides in elite

dynamic and static athletes. Circ J 2003;

: 691-6.

Sundstedt M, Hedberg P, Jonason T,

Ringqvist I, Brodin LA, Henriksen E. Left

ventricular volumes during exercise in

endurance athletes assessed by contrast

echocardiography. Acta Physiol Scand

; 182: 45-51.

Sharma S, Maron BJ, Whyte G, Firoozi S,

Elliott PM, McKenna WJ. Physiologic limits

of left ventricular hypertrophy in elite

junior athletes: relevance to differential

diagnosis of athlete’s heart and hypertrophic

cardiomyopathy. J Am Coll Cardiol

; 40: 1431-6.

Nagashima J, Musha H, Takada H, Murayama

M. New upper limit of physiologic cardiac

hypertrophy in Japanese participants

in the 100-km ultramarathon. J Am Coll

Cardiol 2003 ; 42: 1617-23.

Pelliccia A, Maron BJ, Culasso F, Di Paolo

FM, Spataro A, Biffi A, et al. Clinical significance

of abnormal electrocardiographic

patterns in trained athletes. Circulation

; 102: 278-84.

Palazzuoli A, Gennari L, Calabria P, Nami

R, Martini G, Palazzuoli V, Nuti R. Left

ventricular hypertrophy differences in

male professional runners and in young

patients suffering from mild hypertension.

Blood Press 2004; 13: 14-9.

Kasikcioglu E, Oflaz H, Akhan H, Kayserilioglu

A, Mercanoglu F, Umman B, Bugra

Z. Left ventricular remodeling and aortic

distensibility in elite power athletes. Heart

Vessels 2004; 19: 183-8.

Vinereanu D, Florescu N, Sculthorpe

N, Tweddel AC, Stephens MR, Fraser

AG. Left ventricular long-axis diastolic

function is augmented in the hearts of endurance-

trained compared with strengthtrained

athletes. Clin Sci 2002;103:

-57.

Tanabe K, Yamamoto A, Suzuki N, Akashi

Y, Seki A, Samejima H, et al. Exercise-induced

changes in plasma atrial natriuretic

peptide and brain natriuretic peptide

concentrations in healthy subjects with

chronic sleep deprivation. Jpn Circ J 1999;

: 447-52.

Ohba H, Takada H, Musha H, Nagashima

J, Mori N, Awaya T. Effects of prolonged

strenuous exercise on plasma levels of

atrial natriuretic peptide and brain natriuretic

peptide in healthy men. Am Heart

J 2001; 141: 751-8.

Planer D, Leibowitz D, Hadid A, Erlich

T, Sharon N, Paltiel O, et al. The effect

of prolonged physical activity performed

during extreme caloric deprivation on

cardiac function. PLoS One 2012;7(2):

e31266.

Sahlén A, Winter R, Lind B, Jacobsen PH,

Ståhlberg M, Marklund T, et al. Magnitude,

reproducibility, and association with baseline

cardiac function of cardiac biomarker

release in long-distance runners aged >

or =55. Am J Cardiol. 2008 15; 102(2):

-22.

Herrmann M, Scharhag J, Miclea M, Urhausen

A, Herrmann W and Kindermann W.

Post-Race Kinetics of Cardiac Troponin T

and I and N-Terminal Pro-Brain Natriuretic

Peptide in Marathon Runners. Clin Chem

; 49: 831-34.

Engelmann MD, Niemann L, Kanstrup

IL, Skagen K, Godtfredsen J. Natriuretic

peptide response to dynamic exercise in

patients with atrial fibrillation. Int J Cardiol.

; 105: 31-9.

König D, Schumacher YO, Heinrich

L, Schmid A, Berg A, Dickhuth HH. Myocardial

stress after competitive exercise in

professional road cyclists. Med Sci Sports

Exerc 2003; 35(10): 1679-83.

Mottram PM, Haluska BA, Marwick TH.

Response of B-type natriuretic peptide to

exercise in hypertensive patients with suspected

diastolic heart failure: correlation

with cardiac function, hemo-dynamics, and

workload. Am Heart J 2004; 148: 365-70.

Kruger S, Graf J, Merx MW, Stickel T, Kunz

D, Hanrath P. Brain natriuretic peptide kinetics

during dynamic exercise in patients

with chronic heart failure. Int J Cardiol

; 95: 49-54.