Combined endurance/resistance training reduces NT-proBNP levels in patients with chronic heart failure
European Heart Journal
Aims This study was designed to evaluate the effects of combined endurance/resistance training on NT-proBNP levels in patients with chronic heart failure (CHF). The safety of resistive weight training for patients with CHF is questioned. Possible detrimental effects include an increase in ventricular diastolic pressure and secondary unfavourable remodelling. Circulating levels of the N-terminal fragment of brain natriuretic peptide (NT-proBNP) reflect left ventricular diastolic wall stress and
... ic wall stress and are strongly related to mortality and treatment success in CHF. Methods and results In this study, 27 consecutive patients with stable CHF and left ventricular ejection fraction (LVEF) <35% were enrolled in a 4 months non-randomized combined endurance/resistance training programe. Blood sampling for measurement of NT-proBNP, functional assessment, cardiopulmonary exercise testing, echocardiography and radionuclide angiography were performed at entry and after 4 months. After 4 months, exercise training caused a significant reduction in circulating concentrations of NT-proBNP (2124 ± 397 pg/ml before, 1635 ± 304 pg/ml after training, p = 0.046, interaction), whereas no changes were observed in an untrained heart failure control group. NYHA functional class (p = 0.02, interaction), maximal (peak VO 2 : p = 0.035, interaction; maximal workload: p < 0.00001, interaction) and submaximal (workload at anaerobic threshold: p = 0.001, interaction; rate-pressure product at anaerobic threshold: p = 0.001, interaction) exercise parameters as well as work efficiency (Watt max /VO 2peak : p = 0.0001, interaction) were significantly improved. In addition, a decrease in left ventricular end-systolic diameter was observed in the trained heart failure group (p = 0.016).