Association between resting, postexercise, delta plasma brain natriuretic peptide levels and angiographic coronary heart disease severity and diffuseness in patients with stable angina pectoris.

SUMMARY:ASSOCIATION BETWEEN RESTING, POSTEXERCISE, DELTAPLASMA BRAİN NATRIURETIC PEPTIDE LEVELS ANDANGIOGRAPHIC CORONARY HEART DİSEASE SEVERITY AND DIFFUSENESSIN PATIENTS WITH STABLE ANGINA PECTORISUyar, Samet MD.Dokuz Eylül Üniversitesi Tıp Fakültesi Hastanesi Kardiyoloji A.DAdress: DEUTF Kardiyoloji A.D Balçova/İZMİRe-mail: sametuyar@hotmail.comBackground and aim: The treadmill exercise test which is very important tool in diagnosis,follow up and determining prognosis in patients with stable angina pectoris has somelimitations. In some recent studies, BNP rise by exercise was shown in serious ischemic CHDthat is defined by scintigraphic methods. We aimed to test the value of exercise induced andresting plasma BNP levels in diagnosing severity and diffuseness of angiographic seriousCHD in stable angina pectoris.Method: 45 patient without known CHD, any other chronic illness, or serious structural heartdisease, who have stable angina pectoris and normal left ventriclar ejection fraction (LVEF>%50) were included to study. At resting, before test and immediate after highest workload inexercise testing, the BNP levels were analysed bedside triagemeter machine and recorded inpg/mL. Quantitative coronary angiography was performed in all patients after exercise testing.Results: Similar to other publications, basal BNP levels were elevated by aging (p=0,003).When 22 pg/mL was taken as a cutoff point, the specificity of treadmill exercise testing waselevated from 17,5 to 92,5 % (p=0,01). In patients with serious CHD, postexercise and deltaBNP levels were elevated by the diffüseness of disease from one to multiple vessel disease.Coclusions: When delta BNP cutoff is taken as 22 pg/mL, the specificity of treadmill exercisetesting significantly elevated..Delta BNP was elevated significantly with diffuseness ofserious CHDKey words: stable coronary heart disease (CHD), brain natriüretik protein (BNP), exercisetest, PTP (pretest probabilite)