Augmented Response in Plasma Atrial Natriuretic Peptide to Dynamic Exercise in Patients With Congestive Heart Failure

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概要

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• Neurohormonal activation is present and neurohormonal responses to dynamic exercise are altered in patients with congestive heart failure (CHF). The aim of this study was to determine if the responses of atrial natriuretic peptide (ANP) normalized for peak oxygen consumption (peak VO_2) to exercise are augmented in patients with CHF. Ventilatory and ANP responses were assessed in 28 patients with CHF (NYHA classes II: 16, III: 12), 17 patients in NYHA class I, and 14 normal subjects during symptom-limited cardiopulmonary exercise testing. Plasma ANP was measured at rest and immediately after peak exercise. The increase in ANP was divided by peak VO_2 and this ratio[ANPExercise Ratio: (peak ANP-rest ANP)/peak VO_2]was compared among the 3 groups. Peak VO_2 (Normal, NYHA I, CHF: 29.9±1.7, 24.0±1.3, 17.4±0.8 ml/min per kg), anaerobic threshold and peak work rate were lower in patients with CHF. The resting ANP level was significantly higher in patients with CHF (Normal, NYHA I, CHF: 35, 4±4.6, 42.9±5.8, 80.8±12, 9pg/ml). The ANP level increased during exercise in all 3 groups, and patients with CHF had a significantly higher ANP level than normal subjects and NYHA class I patients (Normal, NYHA I, CHF: 65.3±10.7, 75.9±14.4, 141.6±20, 1pg/ml). The ANP-Exercise Ratio in patients with CHF was significantly higher than those in normal subjects and NYHA class I patients (Normal, NYHA I, CHF: 0.96±0.26, 1.32±0, 38, 3.59±0.72). These data suggest that patients with CHF but not those in NYHA class I have an augmented ANP response, as reflected by both absolute ANP levels and by the exercise ratio, which was normalized by the peak exercise level.

• 社団法人日本循環器学会の論文
• 1996-11-20

著者

• Hisatome Ichiro

  Department Of Regenerative Medicine And Therapeutics Tottori University Graduate School Of Medical S

• Fujimoto Yukihiro

  First Department Of Internal Medicine Tottori University

• Miyakoda Hiroyuki

  Department Of Bioscience National Cardiovascular Center

• Kato Masahiko

  Department Of Cardiovascular Medicine Faculty Of Medicine Tottori University

• Osaki Shuichi

  Department Of Cardiology San-in Rosai Hospital

• Kinugawa Toru

  Kitano Hospital

• Miyakoda Hiroyuki

  1st Department Of Internal Medicine Nagoya University School Of Medicine

• Mashiba Hiroto

  Kure Kyosai Hospital

• Kato Masahiko

  1st Department of Internal Medicine, Tottori University School of Medicine

• Kinugawa Toru

  1st Department of Internal Medicine, Tottori University School of Medicine

• Omodani Hiroki

  1st Department of Internal Medicine, Tottori University School of Medicine

• Osaki Shuichi

  1st Department of Internal Medicine, Tottori University School of Medicine

• Ogino Kazuhide

  1st Department of Internal Medicine, Tottori University School of Medicine

• Hisatome Ichiro

  1st Department of Internal Medicine, Tottori University School of Medicine

• Fujimoto Yukihiro

  1st Department of Internal Medicine, Tottori University School of Medicine

• Kinugawa Tooru

  Kitano Hospital The Tazuke Kofukai Medical Research Institute

• Miyakoda Hiroyuki

  The First Department Of Internal Medicine Tottori University School Of Medicine

• Kinugawa Toru

  Dept. Of Internal Medicine Tottori Univ.

• Omodani Hiroki

  First Department Of Internal Medicine Tottori University

• Fujimoto Yukihiro

  The First Department Of Medicine Tottori University School Of Medicine

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