BACKGROUND:C-type natriuretic peptide (CNP) is structurally related to cardiac natriuretic peptides and is currently considered as an endothelium-derived hyperpolarizing factor. Endothelial dysfunction, commonly observed in chronic heart failure (HF) patients is positively affected by physical training. METHODS: To evaluate the effect of aerobic physical training on the expression of CNP, 90 HF patients on optimal pharmacological treatment (age 62+/-2 years, mean+/-SEM), randomly assigned in a 3 : 1 ratio to either control group (C, 19 patients) or home-based aerobic exercise-training program group (T, 71 patients), completed the protocol. Plasma assay of CNP, brain natriuretic peptide or B-type natriuretic peptide (BNP), and norepinephrine; echocardiogram; and cardiopulmonary-stress test were performed in all patients at enrollment and after 9 months. RESULTS: At baseline, in both groups, CNP plasma level was significantly related to BNP (R=0.50), ejection fraction (R=0.43), and peak oxygen uptake (VO2, R=0.43, all P<0.001). After 9 months, trained patients showed an improvement in peak VO2 (P<0.001) and ejection fraction (P<0.05), whereas norepinephrine (P<0.05), BNP (P<0.001), and CNP (P<0.001) decreased. No changes occurred in group C. In group T, the decrease in CNP was significantly related to the increase in peak VO2 (R=0.31, P<0.01), and the relation between CNP and BNP was preserved at the end of the program (R=0.41, P<0.001). CONCLUSION: Clinical and functional improvement after physical training in HF patients is associated with a decrease in adrenergic activation and in both CNP and BNP concentration. Changes in CNP plasma concentration after physical training might reflect an improvement in endothelial function.
RCT Entities:
BACKGROUND:C-type natriuretic peptide (CNP) is structurally related to cardiac natriuretic peptides and is currently considered as an endothelium-derived hyperpolarizing factor. Endothelial dysfunction, commonly observed in chronic heart failure (HF) patients is positively affected by physical training. METHODS: To evaluate the effect of aerobic physical training on the expression of CNP, 90 HF patients on optimal pharmacological treatment (age 62+/-2 years, mean+/-SEM), randomly assigned in a 3 : 1 ratio to either control group (C, 19 patients) or home-based aerobic exercise-training program group (T, 71 patients), completed the protocol. Plasma assay of CNP, brain natriuretic peptide or B-type natriuretic peptide (BNP), and norepinephrine; echocardiogram; and cardiopulmonary-stress test were performed in all patients at enrollment and after 9 months. RESULTS: At baseline, in both groups, CNP plasma level was significantly related to BNP (R=0.50), ejection fraction (R=0.43), and peak oxygen uptake (VO2, R=0.43, all P<0.001). After 9 months, trained patients showed an improvement in peak VO2 (P<0.001) and ejection fraction (P<0.05), whereas norepinephrine (P<0.05), BNP (P<0.001), and CNP (P<0.001) decreased. No changes occurred in group C. In group T, the decrease in CNP was significantly related to the increase in peak VO2 (R=0.31, P<0.01), and the relation between CNP and BNP was preserved at the end of the program (R=0.41, P<0.001). CONCLUSION: Clinical and functional improvement after physical training in HF patients is associated with a decrease in adrenergic activation and in both CNP and BNP concentration. Changes in CNP plasma concentration after physical training might reflect an improvement in endothelial function.
Authors: Ross Arena; Jonathan Myers; Joshua Abella; Sherry Pinkstaff; Peter Brubaker; Brian Moore; Dalane Kitzman; Mary Ann Peberdy; Daniel Bensimhon; Paul Chase; Daniel Forman; Erin West; Marco Guazzi Journal: Am J Cardiol Date: 2009-08-28 Impact factor: 2.778
Authors: Linda Long; Ify R Mordi; Charlene Bridges; Viral A Sagar; Edward J Davies; Andrew Js Coats; Hasnain Dalal; Karen Rees; Sally J Singh; Rod S Taylor Journal: Cochrane Database Syst Rev Date: 2019-01-29
Authors: Hafiz M Imran; Muhammad Baig; Sebhat Erqou; Tracey H Taveira; Nishant R Shah; Alan Morrison; Gaurav Choudhary; Wen-Chih Wu Journal: J Am Heart Assoc Date: 2019-08-17 Impact factor: 5.501
Authors: Wesley J Tucker; Rhys I Beaudry; Yuanyuan Liang; Alexander M Clark; Corey R Tomczak; Michael D Nelson; Oyvind Ellingsen; Mark J Haykowsky Journal: Prog Cardiovasc Dis Date: 2018-09-15 Impact factor: 8.194
Authors: Rod S Taylor; Viral A Sagar; Ed J Davies; Simon Briscoe; Andrew J S Coats; Hayes Dalal; Fiona Lough; Karen Rees; Sally Singh Journal: Cochrane Database Syst Rev Date: 2014-04-27