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A systematic review of the effect of aerobic and resistance exercise training on systemic brain natriuretic peptide (BNP) and N-Terminal BNP expression in heart failure patients
Abstracts
this community-based study of healthy children, we determined the association between MetS and cardiac structure and carotid-femoral pulse wave velocity (PWV), an index of central arterial stiffness. Methods: Four hundred and thirty-nine non-diabetic children (mean age 10.1 ± 0.3 years; 51% boys) underwent clinical examination, a fasting blood test, and assessment of cardiac structure and function by echocardiography. Cardiorespiratory fitness and physical activity levels were determined using a 20-m shuttle run and 7-day pedometer count, respectively. PWV was estimated by applanation tonometry. MetS status was based on previously published guidelines for children. Results: Of the 8 (1.8%) subjects with 3 or more MetS components, 7 were girls (Table). In multivariable analysis, MetS was positively associated with left atrial and ventricular volumes, left ventricular mass, pulse pressure and PWV (all p < 0.01), independent of gender and fitness. Conclusion: MetS is associated with altered cardiac structure and increased arterial stiffness in prepubescent children. Metabolic Syndrome Score 0 (n = 330) Cardiorespiratory fitness (Stage) Body mass index (kg/m2 ) Pulse wave velocity (m/s) Left ventricular mass (g/m2.7 )
1–2 (n = 101)
p-value
3+ (n = 8)
4.6
3.5
<0.001
17.2
20.8
25.9
<0.001
4.3
4.6
4.6
<0.001
34
37
resistance exercise training in heart failure patients that measured BNP and/or ProBNP. Primary outcome measures were change in BNP and NT-proBNP. Secondary outcomes were change in functional capacity, exercise energy expenditure and measures of study quality. Results: Seven randomized controlled studies measuring BNP or NT-pro BNP met our eligibility criteria, including 411 subjects (230 exercise participants and 181 controls). Participants were matched for age and mostly male (50–89%) and New York Heart Association (NYHA) class I–II. Exercise training had a favourable effect on NTproBNP −679 pg/ml 95% C.I. (−756 to −601) p = <0.00001. Moreover the trials that showed a significant change in NT-proBNP all had a weekly exercise energy expenditure of more than 400 kcal. Conclusion: Data from seven published studies, suggest exercise training has a favorable effect on NT-proBNP in heart failure patients. Moreover our data suggest that exercise intensity and weekly minimum exercise energy expenditure may determine the magnitude and rate of change in the N-terminal portion of BNP in heart failure patients. doi:10.1016/j.hlc.2009.05.629
5.3
32
S255
<0.001
doi:10.1016/j.hlc.2009.05.628 Rehabilitation, Exercise and Prevention 583 A SYSTEMATIC REVIEW OF THE EFFECT OF AEROBIC AND RESISTANCE EXERCISE TRAINING ON SYSTEMIC BRAIN NATRIURETIC PEPTIDE (BNP) AND N-TERMINAL BNP EXPRESSION IN HEART FAILURE PATIENTS N. Smart, M. Steele Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia Background: BNP and the N-terminal portion (NTproBNP) have emerged as powerful tools in the diagnosis and prognosis of heart failure on acute presentation. The aim of this work was to systematically review the effect of exercise training on BNP and NT-proBNP levels in patients with left ventricular dysfunction. Methods: A systematic search was conducted of Medline (Ovid) (1950–July 2008), Embase.com (1974–current), Cochrane Central Register of Controlled Trials, CINAHL (1981–current) and Web of Science (2000–current) to identify randomized controlled trials of aerobic and/or
584 A WORKING MODEL OF HOW TAI CHI HAS BEEN INCORPORATED INTO A CARDIAC REHABILITATION PROGRAM K. McCleary St. Vincent’s Hospital, Sydney, Australia Aim: To provide details of the working-model of how St. Vincent’s Hospital implemented a Tai Chi component into the existing cardiac rehabilitation exercise structure. Background: In 2008 the Cardiac Rehabilitation exercise program was reviewed and restructured by the physiotherapy department. Traditional Cardiac Rehabilitation programs contain a stretching element, upper limb weight exercises and an aerobic component. There is an abundance of research to support the benefits of the aerobic exercise component for heart disease patients, but little recent supportive literature for the benefits of warm-up stretches and upper limb weight exercises in this patient group. Much of the current research suggests that stretches are ineffective in reducing injuries, preventing delayed-onset muscle soreness and increasing muscle flexibility. The weight-exercise program for the upper limbs has been shown to be detrimental to the patient’s recovery, leading to sternal instability in at-risk patient groups. Conclusively, it was determined that a Tai Chi Exercise program would be implemented in place of the general stretching and upper-limb weight exercise components due to its researched benefits. Tai Chi has been shown to reduce stress, improve balance and flexibility, and reduce the incidence of falls –
ABSTRACTS
Heart, Lung and Circulation 2009;18S:S1–S286
this community-based study of healthy children, we determined the association between MetS and cardiac structure and carotid-femoral pulse wave velocity (PWV), an index of central arterial stiffness. Methods: Four hundred and thirty-nine non-diabetic children (mean age 10.1 ± 0.3 years; 51% boys) underwent clinical examination, a fasting blood test, and assessment of cardiac structure and function by echocardiography. Cardiorespiratory fitness and physical activity levels were determined using a 20-m shuttle run and 7-day pedometer count, respectively. PWV was estimated by applanation tonometry. MetS status was based on previously published guidelines for children. Results: Of the 8 (1.8%) subjects with 3 or more MetS components, 7 were girls (Table). In multivariable analysis, MetS was positively associated with left atrial and ventricular volumes, left ventricular mass, pulse pressure and PWV (all p < 0.01), independent of gender and fitness. Conclusion: MetS is associated with altered cardiac structure and increased arterial stiffness in prepubescent children. Metabolic Syndrome Score 0 (n = 330) Cardiorespiratory fitness (Stage) Body mass index (kg/m2 ) Pulse wave velocity (m/s) Left ventricular mass (g/m2.7 )
1–2 (n = 101)
p-value
3+ (n = 8)
4.6
3.5
<0.001
17.2
20.8
25.9
<0.001
4.3
4.6
4.6
<0.001
34
37
resistance exercise training in heart failure patients that measured BNP and/or ProBNP. Primary outcome measures were change in BNP and NT-proBNP. Secondary outcomes were change in functional capacity, exercise energy expenditure and measures of study quality. Results: Seven randomized controlled studies measuring BNP or NT-pro BNP met our eligibility criteria, including 411 subjects (230 exercise participants and 181 controls). Participants were matched for age and mostly male (50–89%) and New York Heart Association (NYHA) class I–II. Exercise training had a favourable effect on NTproBNP −679 pg/ml 95% C.I. (−756 to −601) p = <0.00001. Moreover the trials that showed a significant change in NT-proBNP all had a weekly exercise energy expenditure of more than 400 kcal. Conclusion: Data from seven published studies, suggest exercise training has a favorable effect on NT-proBNP in heart failure patients. Moreover our data suggest that exercise intensity and weekly minimum exercise energy expenditure may determine the magnitude and rate of change in the N-terminal portion of BNP in heart failure patients. doi:10.1016/j.hlc.2009.05.629
5.3
32
S255
<0.001
doi:10.1016/j.hlc.2009.05.628 Rehabilitation, Exercise and Prevention 583 A SYSTEMATIC REVIEW OF THE EFFECT OF AEROBIC AND RESISTANCE EXERCISE TRAINING ON SYSTEMIC BRAIN NATRIURETIC PEPTIDE (BNP) AND N-TERMINAL BNP EXPRESSION IN HEART FAILURE PATIENTS N. Smart, M. Steele Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia Background: BNP and the N-terminal portion (NTproBNP) have emerged as powerful tools in the diagnosis and prognosis of heart failure on acute presentation. The aim of this work was to systematically review the effect of exercise training on BNP and NT-proBNP levels in patients with left ventricular dysfunction. Methods: A systematic search was conducted of Medline (Ovid) (1950–July 2008), Embase.com (1974–current), Cochrane Central Register of Controlled Trials, CINAHL (1981–current) and Web of Science (2000–current) to identify randomized controlled trials of aerobic and/or
584 A WORKING MODEL OF HOW TAI CHI HAS BEEN INCORPORATED INTO A CARDIAC REHABILITATION PROGRAM K. McCleary St. Vincent’s Hospital, Sydney, Australia Aim: To provide details of the working-model of how St. Vincent’s Hospital implemented a Tai Chi component into the existing cardiac rehabilitation exercise structure. Background: In 2008 the Cardiac Rehabilitation exercise program was reviewed and restructured by the physiotherapy department. Traditional Cardiac Rehabilitation programs contain a stretching element, upper limb weight exercises and an aerobic component. There is an abundance of research to support the benefits of the aerobic exercise component for heart disease patients, but little recent supportive literature for the benefits of warm-up stretches and upper limb weight exercises in this patient group. Much of the current research suggests that stretches are ineffective in reducing injuries, preventing delayed-onset muscle soreness and increasing muscle flexibility. The weight-exercise program for the upper limbs has been shown to be detrimental to the patient’s recovery, leading to sternal instability in at-risk patient groups. Conclusively, it was determined that a Tai Chi Exercise program would be implemented in place of the general stretching and upper-limb weight exercise components due to its researched benefits. Tai Chi has been shown to reduce stress, improve balance and flexibility, and reduce the incidence of falls –
ABSTRACTS
Heart, Lung and Circulation 2009;18S:S1–S286