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Exercise release of cardiac natriuretic peptides is markedly enhanced when patients with coronary artery disease are treated medically by beta-blockers

Pierre-Yves Marie, MD^*,*, Paul M. Mertes, MD, Nathalie Hassan-Sebbag, MD^*, Nicole de Talence, MD, Karim Djaballah, MD, Wassila Djaballah, MD^*, Johan Friberg, MD^*, Pierre Olivier, MD^*, Gilles Karcher, MD^*, Faïez Zannad, MD and Alain Bertrand, MD^*

^* Nuclear Medicine, UPRES EA 3447, Nancy, France
Physiology, UPRES EA 3447, Nancy, France
Cardiology, UPRES EA 3447, Nancy, France

View larger version (21K): [in a new window]   Figure 1 Total plasma venous concentrations of natriuretic peptides determined at rest for patients stratified into three groups as a function of the extent of predominantly scarred left ventricular (LV) myocardium on thallium-201 single-photon emission computed tomography (0%, 1%–19%, and 20%) and into two subgroups according to age: <65 years (white bars) and 65 years (black bars). The hatched portion of each bar represents the part related to the atrial natriuretic peptide concentration and the open portion to brain natriuretic peptide.

View larger version (26K): [in a new window]   Figure 2 Evolution of the plasma venous concentrations of natriuretic peptides at rest, maximal exercise, and 20-min recovery, as well as the exercise increase and post-exercise decrease in natriuretic peptide concentration, for patients stratified according to the presence (black bars) or absence (white bars) of either beta-blocker treatment (upper half; n = 55/n = 49) or a significant left ventricular scarred area on thallium-201 single-photon emission computed tomography (lower half; n = 47/n = 57). The hatched portion of each bar represents the part related to the atrial natriuretic peptide concentration and the open portion of each bar represents the brain natriuretic peptide. *p < 0.05.

View larger version (27K): [in a new window]   Figure 3 Exercise increase in the total plasma venous concentrations of natriuretic peptides, as determined by the difference between exercise and rest values (top), or as percentages of the baseline resting values (bottom) for patients stratified into two groups according to the exercise increase in heart rate (< or 51 beats/min) and into two subgroups as a function of the presence (black bars) or absence (white bars) of beta-blocker treatment. The hatched portion of each bar represents the part related to the atrial natriuretic peptide concentration and the open portion of each bar represents the brain natriuretic peptide. *p < 0.05.