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B-type natriuretic peptide in reversible myocardial ischaemia
  1. K Chatha1,
  2. M Alsoud2,
  3. M J Griffiths1,
  4. A Elfatih1,
  5. K Abozguia2,
  6. R C Horton2,
  7. S J Dunmore3,
  8. R Gama1
  1. 1Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, UK
  2. 2Department of Cardiology, New Cross Hospital, Wolverhampton, UK
  3. 3Research Institute, Healthcare Sciences, Wolverhampton University, Wolverhampton, UK
  1. Correspondence to:
    R Gama
    Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands WV10 0QP, UK; rousseau.gama{at}


Background: Coronary heart disease is associated with increased B-type natriuretic peptides (BNPs), and, although controversial, may cause exaggerated exercise-induced BNP secretion. We investigated BNP in relation to reversible myocardial ischaemia.

Materials and methods: Serum N-terminal proBNP (NT-proBNP) was measured before and after an exercise electrocardiogram test (ETT) in 14 patients with and 45 patients without exercise-induced myocardial ischaemia. Statistical analysis was carried out on logarithmically transformed data. Results, however, are pre-transformed data.

Results: NT-proBNP increased with exercise both in ETT-positive patients (mean (SD) 71.4 (41.2) v 76.8 (44.0) ng/l; p<0.001) and ETT-negative patients (54.0 (61.2) v 60.1 (69.0) ng/l; p<0.001). Pre-exercise and post-exercise NT-proBNP were higher (p<0.05) in ETT-positive than in ETT-negative patients. Incremental NT-proBNP was similar in ETT-positive (4.7 (4.2) ng/l) and ETT-negative (6.2 (8.6) ng/l) patients.

Conclusion: Serum NT-proBNP concentrations are higher in patients with exercise-induced myocardial ischaemia than in those without. Exercise-induced electrocardiographic myocardial ischaemia, however, is not associated with exaggerated BNP secretion.

  • BNP, B-type natriuretic peptide
  • CHD, Coronary heart disease
  • ETT, electrocardiogram test
  • NT-proBNP, N-terminal proBNP

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  • Competing interests: None.

  • Ethical approval: The Wolverhampton District Local Research Ethics Committee approved the study.