PLASMA BRAIN NATRIURETIC PEPTIDE DURING ERGOMETRIC EXERCISE IN HYPERTENSIVE PATIENTS WITH LEFT-VENTRICULAR HYPERTROPHY

Cardiac ventricle is shown to be an important source of circulating br ain natriuretic peptide (BNP) in hypertensive rats with left ventricul ar hypertrophy (LVH). This study examined the effect of short-term exe rcise with a bicycle ergometer on plasma BNP concentrations in 21 esse ntial hypertension patients with LVH established by echocardiography. The results were compared with those from 24 age-matched hypertensives without LVH. Blood pressure, heart rate, plasma renin activity (PRA), and plasma norepinephrine level increased during exercise, but the me an increases of these parameters were not different in the two groups. Resting BNP levels were slightly but significantly higher in the LVH group than in the non-LVH group. This peptide increased during exercis e in the two groups, but the exercise-induced increase (percent increa se) in plasma BNP was significantly greater in the LVH group than in t he non-LVH group (207% +/- 50% v 141% +/- 36%, P <.05). The exercise-i nduced increase in BNP was significantly correlated with the left vent ricular (LV) mass index (N = 45, r = .60, P <.01). By contrast, the ex ercise-induced increase in BNP was not correlated with the exercise-in duced increase in heart rate, systolic blood pressure, diastolic blood pressure, mean brood pressure, PRA, or noradrenaline level. These res ults suggest that short-term exercise induces an accelerated increase of plasma BNP in hypertensive subjects with LVH. The LV mass appeared to be related to the observed increase of plasma BNP concentration, at least in our hypertensive patients with LVH. Copyright (C) 1996 by W. B. Saunders Company