Clinical InvestigationAcute Ischemic Heart DiseasePercent change in B-type natriuretic peptide levels during treadmill exercise as a screening test for exercise-induced myocardial ischemia
Section snippets
Methods
Sixty consecutive patients undergoing myocardial single-photon emission computed tomography (SPECT) in conjunction with Bruce protocol treadmill exercise for evaluation of chest pain or screening for ischemia were enrolled into our study. Exclusion criteria were defined as follows: clinical heart failure (New York Heart Association class ≥II), known left ventricular ejection fraction of <40%, unstable angina, recent evidence of myocardial infarction (<6 weeks), and known moderate-to-severe
Patient population
Sixty consecutive patients who met the criteria for inclusion were enrolled in the study. There were 41 men and 19 women, with a mean age of 57.2 ± 9.3 years. Diabetes was present in 18% of the patients. Twenty-three percent were taking β-blockers, 15% were taking angiotensin-converting enzyme inhibitors, and 11% were taking calcium-channel blockers.
Ten patients, all men, had reversible myocardial perfusion defects by SPECT (mean defect size 14%, range 5%-37%). Postexercise ejection fraction
Discussion
The present study demonstrates that, in subjects without heart failure undergoing routine treadmill exercise test for evaluation of ischemia, BNP levels increase significantly from rest to immediate postexercise and decrease toward baseline levels within 10 to 15 minutes after exercise. This transient rise in BNP levels during treadmill exercise is observed in patients with and without ischemia but is more pronounced in patients with ischemia, particularly when baseline levels, sex, and
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