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Exercise Cuts Natriuretic Peptides in Heart Failure

Patients have improved symptoms, quality of life, drop in neurohormone levels

TUESDAY, May 9 (HealthDay News) -- For patients with chronic heart failure due to left ventricular systolic dysfunction, an exercise program can improve symptoms, quality of life and ejection fraction, and lead to a drop in neurohormone levels, according to a study in the May 2 issue of the Journal of the American College of Cardiology.

Claudio Passino, M.D., of the CNR Institute of Clinical Physiology in Pisa, Italy, and colleagues assessed the effect of exercise on neurohormonal activation in 85 patients with chronic heart failure due to impaired left ventricular systolic function. The researchers randomized 44 patients to a nine-month exercise program at 60 percent of the maximal oxygen uptake and 41 to standard care.

Patients who completed the exercise program had a 14 percent improvement in workload, a 13 percent increase in peak maximal oxygen uptake, a 9 percent improvement in ejection fraction and an improvement in quality of life. After training, plasma levels of B-type natriuretic peptide fell by 34 percent, amino-terminal pro-brain natriuretic peptide fell by 32 percent, and norepinephrine fell by 26 percent. The increase in peak maximal oxygen uptake was significantly associated with the drop in both B-type natriuretic peptide and amino-terminal pro-brain natriuretic peptide, according to the study.

"Clinical benefits after physical training in patients with heart failure are associated with blunting of adrenergic overactivity and of natriuretic peptide overexpression," Passino and colleagues conclude.

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