Skip Navigation

European Heart Journal 1997 18(11):1749-1754;
Copyright © 1997 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Davidson, N. C.
Right arrow Articles by Struthers, A. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Davidson, N. C.
Right arrow Articles by Struthers, A. D.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1997 The European Society of Cardiology

Right coronary artery stenosis is associated with impaired cardiac endocrine function during exercise

N. C. Davidson{dagger}, S. D. Pringle*, T. H. Pringle*, G. P. McNeill* and A. D. Struthers{dagger},

{dagger}Departments of Clinical Pharmacology, Ninewells Hospital and Medical School Dundee, U.K.
*Departments of cardiology, Ninewells Hospital and Medical School Dundee, U.K.

revised 9 April 1997; accepted 16 May 1997.

Correspondence: Professor A. D. Struthers, Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee DD1 9SY, U.K.

Abstract

AIMS: Resting plasma levels of atrial natriuretic peptide and B-type natriuretic peptide rise with left ventricular dysfunction, but little is known about effects of cardiac ischaemia on atrial natriuretic peptide and B-type natriuretic peptide levels during exercise. We investigated exercise levels of atrial natriuretic peptide and B-type natriuretic peptide in patients with suspected angina to determine whether these measurements could improve non-invasive assessment of coronary disease severity.

METHODS AND RESULTS: One hundred patients performed an exercise test (Bruce protocol) within 2 weeks of coronary angiography. Plasma levels of atrial natriuretic peptide and B-type natriuretic peptide were measured at rest and at peak exercise. Multivariate regression analysis was used to assess effects of age, sex, coronary anatomy, exercise time and ventricular function on atrial natriuretic peptide and B-type natriuretic peptide levels. Increasing age and female sex were significantly associated with higher resting atrial natriuretic peptide levels; age alone was associated with higher exercise atrial natriuretic peptide levels. As expected, left ventricular end-diastolic pressure and disease of left anterior descending and circumflex coronary arteries were associated with increased resting B-type natriuretic peptide levels. However, the usual rise in B-type natriuretic peptide levels during exercise was independently reduced by disease of the right coronary artery.

CONCLUSION: This paradoxical effect of right coronary artery disease limits the value of natriuretic peptide measurements as predictors of coronary disease severity. Impaired release of B-type natriuretic peptide may reduce exercise tolerance in patients with right coronary artery disease.

Key Words: Atrial natriuretic peptide • B-type natriuretic peptide • angina • exercise testing


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 QJMHome page
A. Brown, J. George, M.J. Murphy, and A. Struthers
Could BNP screening of acute chest pain cases lead to safe earlier discharge of patients with non-cardiac causes? A pilot study
QJM, December 1, 2007; 100(12): 755 - 761.
[Abstract] [Full Text] [PDF]

Home page
 QJMHome page
S.B. Connolly, T. Collier, R. Khugputh, D. Tataree, K. Kyereme, S. Merritt, A.D. Struthers, and K.F. Fox
Brain natriuretic peptide testing for angina in a rapid-access chest pain clinic
QJM, December 1, 2007; 100(12): 779 - 783.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
A. Struthers and C. Lang
The potential to improve primary prevention in the future by using BNP/N-BNP as an indicator of silent 'pancardiac' target organ damage: BNP/N-BNP could become for the heart what microalbuminuria is for the kidney
Eur. Heart J., July 2, 2007; 28(14): 1678 - 1682.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
B S Rana, J I Davies, M M Band, S D Pringle, A Morris, and A D Struthers
B-type natriuretic peptide can detect silent myocardial ischaemia in asymptomatic type 2 diabetes
Heart, July 1, 2006; 92(7): 916 - 920.
[Abstract] [Full Text] [PDF]

Home page
 QJMHome page
A.D. Struthers and J. Davies
B-type natriuretic peptide: a simple new test to identify coronary artery disease?
QJM, October 1, 2005; 98(10): 765 - 769.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
G. G.L. Biondi-Zoccai, A. Abbate, L. M. Biasucci, P. R. Kalra, R. Sharma, A. D. Struthers, J. A. de Lemos, D. A. Morrow, and E. Braunwald
B-Type Natriuretic Peptide and Acute Coronary Syndromes
N. Engl. J. Med., February 7, 2002; 346(6): 453 - 455.
[Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.