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

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Authors
Smart, N A
Meyer, T
Butterfield, J A
Faddy, S C
Passino, C
Malfatto, G
Jonsdottir, S
Sarullo, F
Wisloff, U
Vigorito, C
Giallauria, F
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Issue Date
2012-06

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Citation
Eur J Prev Cardiol 2012, 19(3):428-35
Abstract
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. 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). Individual patient meta-analysis. 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. 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.
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Additional Links
http://dx.doi.org/10.1177/1741826711409171
http://cpr.sagepub.com/content/19/3/428.full.pdf+html
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Archived with thanks to European journal of preventive cardiology
ae974a485f413a2113503eed53cd6c53
10.1177/1741826711409171
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English Journal Articles (Peer Reviewed)

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