Abstract
Background There is accumulating evidence that transient exercise-induced ischemia triggers the release of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). The aim of this study was to either confirm or refute a previous investigation suggesting that myocardial ischemia can reliably be detected by exercise-induced changes in BNP or NT-proBNP levels in selected patients. Methods A total of 139 consecutive patients with normal left ventricular function and normal resting BNP and NT-proBNP levels referred for rest/stress myocardial perfusion single-photon emission computed tomography (SPECT) were analyzed. Levels of BNP and NT-proBNP were determined before and immediately after symptom-limited bicycle ergometry. Results Inducible myocardial ischemia on perfusion images was detected in 46 patients (33%). Median exercise-induced increases in BNP (ΔBNP) and NT-proBNP (ΔNT-proBNP) were similar in patients with and without inducible ischemia (ΔBNP 12.7 pg/ml vs. 9.4 pg/ml, p = 0.109; ΔNT-proBNP 7 pg/ml vs. 6 pg/ml, p = 0.309). The area under the receiver operating characteristic curve for the ability to detect myocardial ischemia was 0.583 (95% CI, 0.479–0.688) for ΔBNP, and 0.553 (95% CI, 0.450–0.656) for ΔNT-proBNP. Conclusions Exercise-induced changes in BNP and NT-proBNP do not reliably detect myocardial ischemia in selected patients.
Published Version
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