Individual patient meta-analysis of exercise training effects on systemic brain natriuretic peptide expression in heart failure

N. A. Smart, T. Meyer, J. A. Butterfield, S. C. Faddy, C. Passino, G. Malfatto, S. Jonsdottir, F. Sarullo, U. Wisloff, C. Vigorito, F. Giallauria

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Brain natriuretic peptide (BNP) predicts exercise performance and exercise training may modulate BNP and its N-terminal portion (NT-pro-BNP), we therefore conducted an individual patient analysis of exercise training effects on BNP and NT-pro-BNP. Aims: To use an individual patient meta-analysis to relate changes in BNP, NT-pro-BNP, and peak VO2; to link these changes to volume parameters of exercise training programmes (intensity etc.); and to identify patient characteristics likely to lead to greater improvements in BNP, NT-pro-BNP, and peak VO2. Design: Individual patient meta-analysis. Methods: A systematic search was conducted of Medline (Ovid), Embase.com, Cochrane Central Register of Controlled Trials, and CINAHL (until July 2008) to identify randomized controlled trials of aerobic and/or resistance exercise training in systolic heart failure patients measuring BNP and/or NT-pro-BNP. Primary outcome measures were change in BNP, NT-pro-BNP, and peak VO2. Subanalyses were conducted to identify (1) patient groups that benefit most and (2) exercise programme parameters enhancing favourable changes in primary outcome measures. Results: Ten randomized controlled studies measuring BNP or NT-pro-BNP met eligibility criteria, authors provided individual patient data for 565 patients (313 exercise and 252 controls). Exercise training had favourable effects on BNP (-28.3%, p <0.0001), NT-pro-BNP (-37.4%, p = <0.0001), and peak VO2 (17.8%, p <0.0001). The analysis showed a significant change in primary outcome measures; moreover, change in BNP (r = -0.31, p <0.0001) and NT-pro-BNP (r = -0.22, p <0.0001) were correlated with peak VO2 change. Conclusion: Exercise training has favourable effects on BNP, NT-pro-BNP, and peak VO2 in heart failure patients and BNP/NT-pro-BNP changes were correlated with peak VO2 changes.

Original languageEnglish
Pages (from-to)428-435
Number of pages8
JournalEuropean Journal of Preventive Cardiology
Volume19
Issue number3
DOIs
Publication statusPublished - Jun 2012

Keywords

  • Exercise training
  • heart failure
  • meta-analysis
  • natriuretic peptides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Epidemiology

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