Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2010, vol. 19, nr 2, March-April, p. 185–193

Publication type: original article

Language: English

The Influence of Increasing Physical Effort on the Concentrations of Selected Neurohormonal Factors in Patients with Heart Failure

Wpływ wysiłku fizycznego o wzrastającej intensywności na stężenie wybranych czynników neurohormonalnych u pacjentów z niewydolnością serca

Tomasz Grzebieniak1,, Beata Jołda-Mydłowska1,, Jacek Arkowski1,, Walentyna Mazurek1,, Jan Juzwiszyn2,

1 Chair and Department of Cardiology, Wroclaw Medical University, Poland

2 Department of Operative Specialties, Wroclaw Medical University, Poland

Abstract

Background, The incidence of diagnosed cases of heart failure is increasing. There have been some studies exploring the influence of physical exercise on the course of heart failure, but the influence of physical effort on the concentrations of neurohormonal factors crucial for the pathogenesis of heart failure remains unknown.
Objectives. To investigate the influence of physical effort on the concentrations of the neurohumoral factors atrial natriuretic peptide, brain natriuretic peptide, endothelin-1, nitric oxide, von Willebrand factor (vWf), adrenaline, and noradrenaline in patients with heart failure.
Material and Methods. The study was carried out on 39 patients with diagnosed heart failure. The control group consisted of 25 healthy volunteers. In both groups the concentrations of the selected factors in blood serum were measured at baseline and directly after an exercise test.
Results. In the heart failure group the change in nitric oxide concentration during exercise significantly correlated with left atrium diameter, while in the control group it correlated with the duration and intensity of exercise. In the heart failure group the statistically significant change in vWf concentration after exercise significantly correlated with interventricular septum thickness, whereas in the control group it correlated with the patient’s body mass.
Conclusion. The decrease in vWf concentration seen in the group of HF patients seems to be significant marker of endothelial dysfunction. The lack of statistically significant differences in the concentrations of the other studied factors after physical exercise may suggest similarities between the two groups, which may justify the use of exercise in the rehabilitation and treatment of patients with heart failure.

Streszczenie

Wprowadzenie. Liczba rozpoznanych przypadków niewydolności serca stale wzrasta. Pojawiają się doniesienia o wpływie wysiłku fizycznego na przebieg niewydolności serca (n.s.). Wpływ wysiłku fizycznego na stężenia czynników neurohormonalnych odgrywających kluczową rolę w patogenezie niewydolności serca pozostaje jednak nieznany.
Cel pracy. Zbadanie wpływu wysiłku fizycznego na zmiany stężenia przedsionkowego peptydu natriuretycznego, mózgowego peptydu natriuretycznego, endoteliny-1, tlenku azotu, czynnika von Willebranda, adrenaliny i noradrenaliny u pacjentów z niewydolnością serca.
Materiał i metody. Badanie przeprowadzono u 39 chorych z rozpoznaną niewydolnością serca. Grupę kontrolną stanowiło 25 zdrowych ochotników. W obu grupach oznaczono stężenie wybranych czynników neurohormonalnych (przedsionkowego peptydu natriuretycznego, mózgowego peptydu natriuretycznego, endoteliny-1, tlenku azotu, czynnika von Willebranda, adrenaliny i noradrenaliny) w surowicy krwi w spoczynku i po zakończeniu testu wysiłkowego.
Wyniki. W grupie chorych z niewydolnoscią serca zmiana stężenia tlenku azotu wykazuje istotną korelację ze średnicą lewego przedsionka, a u osób z grupy kontrolnej z czasem trwania i intensywnością wysiłku. U chorych z niewydolnością serca istotna statystycznie zmiana stężenia czynnika von Willebranda po wysiłku wykazuje istotną korelację z grubością przegrody międzykomorowej, podczas gdy u osób z grupy kontrolnej wykazuje korelację z masą ciała.
Wnioski. Zmniejszenie stężenia czynnika Willebranda wydaję się istotnym markerem dysfunkcji śródbłonka w obserwowanej grupie chorych na n.s. Brak istotnych statystycznie różnic w stężeniach pozostałych badanych substancji po wysiłku fizycznym może świadczyć o podobieństwach między grupami, co uzasadnia stosowanie ćwiczeń fizycznych w rehabilitacji i leczeniu chorych z niewydolnością serca.

Key words

heart failure, physical exercise, neurohormonal factors

Słowa kluczowe

niewydolność serca, wysiłek fizyczny, czynniki neurohormonalne

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