© 2001 by European Society of Cardiology
Copyright © 2000, European Society of Cardiology
Cardiac natriuretic peptides during exercise and training after heart transplantation
Laboratoire des Régulations Physiologiques et des Rythmes Biologiques chez l'Homme, EA 3072, Institut de Physiologie, Faculté de Médecine, Strasbourg, France
* Corresponding author. Tel.: +33-390-243-439; fax: +33-390-243-444 bernard.geny@physio-ulp.u-strasbg.fr
Received 14 November 2000; accepted 5 February 2001
KEYWORDS Natriuretic peptide; Transplantation
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1 Introduction |
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The cardiac natriuretic system, composed of atrial and brain natriuretic peptides (ANP and BNP), plays a major role in blood pressure and fluid homeostasis, protecting the organism from volume and pressure overloads. Accordingly, the cardiac hormones have been shown to delay the occurrence of overt heart failure through their diuretic, natriuretric and vasodilatory properties [1–3]. Adrenomedullin, mainly produced by vascular smooth muscle cells and by vascular endothelial cells, is also secreted by the failing human heart. This potent vasorelaxing and natriuretic peptide can thus be considered as a third cardiac hormone, involved in circulation control [4,5].
Short term survival is no longer the pivotal issue for most heart-transplant recipients (Htx) because of enhancement in organ preservation, surgical and medical therapies. Consequently, improving quality of life after heart transplantation arises as an important goal, which might be reached through exercise and training programs [6–8]. Since cardiac natriuretic peptides
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2 Increased circulating cardiac natriuretic peptides after heart transplantation |
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3 Cardiac natriuretic peptides responses to exercise after heart transplantation |
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3.1 Stimuli for ANP secretion
3.1.1 Altered atrial anatomy
3.1.2 Humoral modulation
3.1.3 Therapy
3.1.4 Cardiac denervation and atrial stretch
3.2 Stimuli for BNP secretion in Htx
3.2.1 Atrial stretch leading to ANP and BNP cosecretion
3.2.2 Ventricular hypertrophy
3.2.3 Cardiac diastolic dysfunction
3.3 Stimuli for adrenomedullin release during exercise after cardiac transplantation
3.3.1 Heart rate
3.3.2 Exercise intensity and duration
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4 Cardiac natriuretic peptides and training after heart transplantation |
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