Article

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 VO(2); 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 VO(2). 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 VO(2) (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 VO(2) change. Conclusion: Exercise training has favourable
effects on BNP, NT-pro-BNP, and peak VO(2) in heart failure patients and
BNP/NT-pro-BNP changes were correlated with peak VO(2) changes.

Langue : ANGLAIS