The Role of Cardiac Rehabilitation Using Exercise to Decrease Natriuretic Peptide Levels in Non-surgical Patients: a Systematic Review

Overview

Journal Perioper Med (Lond)

Publisher Biomed Central

Date 2019 Dec 14

PMID 31832178

Citations 1

Authors

Christella S Alphonsus

Pooveshni Govender

Reitze N Rodseth

Bruce M Biccard

Affiliations

Soon will be listed here.

Abstract

Exercise is recommended in patients with cardiac failure. In the perioperative patient, exercise is also gaining popularity as a form of prehabilitation. In this meta-analysis, we examine if exercise is able to reduce natriuretic peptide levels. Natriuretic peptide (NP) has strong prognostic ability in identifying patients who will develop adverse postoperative cardiovascular outcomes. The protocol was registered with PROSPERO (CRD42017051468). The database search included MEDLINE (PubMed), CINAHL (EBSCO host), EMBASE (EBSCO host), ProQuest, Web of Science, and Cochrane database. The primary outcomes were to determine whether exercise therapy was effective in reducing NP levels as compared to control group, the shortest time period required to reduce NP levels after exercise therapy, and whether reducing NP levels decreased morbidity and mortality. Full texts of 16 trials were retrieved for this review. Exercise therapy showed a significant reduction in natriuretic peptide levels between the intervention and control groups (SMD - 0.45, 95% CI - 0.88 to - 0.03) with significant heterogeneity between the included trials. This was also shown in the within a 12-week period.

Citing Articles

Natriuretic peptide-directed medical therapy: a systematic review.

Alphonsus C, Govender P, Rodseth R, Biccard B Perioper Med (Lond). 2020; 9:5.

PMID: 32095234 PMC: 7027249. DOI: 10.1186/s13741-019-0134-y.

References

Jonsdottir S, Andersen K, Sigurosson A, Sigurosson S . The effect of physical training in chronic heart failure. Eur J Heart Fail. 2005; 8(1):97-101. DOI: 10.1016/j.ejheart.2005.05.002. View

Duceppe E, Parlow J, MacDonald P, Lyons K, McMullen M, Srinathan S . Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery. Can J Cardiol. 2016; 33(1):17-32. DOI: 10.1016/j.cjca.2016.09.008. View

Alphonsus C, Govender P, Rodseth R, Biccard B . Natriuretic peptide-directed medical therapy: a systematic review. Perioper Med (Lond). 2020; 9:5. PMC: 7027249. DOI: 10.1186/s13741-019-0134-y. View

Malfatto G, Branzi G, Osculati G, Valli P, Cuoccio P, Ciambellotti F . Improvement in left ventricular diastolic stiffness induced by physical training in patients with dilated cardiomyopathy. J Card Fail. 2009; 15(4):327-33. DOI: 10.1016/j.cardfail.2008.10.032. View

Guazzi M, Vitelli A, Arena R . The effect of exercise training on plasma NT-pro-BNP levels and its correlation with improved exercise ventilatory efficiency in patients with heart failure. Int J Cardiol. 2012; 158(2):290-1. DOI: 10.1016/j.ijcard.2012.04.091. View

Wan X, Wang W, Liu J, Tong T . Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol. 2014; 14:135. PMC: 4383202. DOI: 10.1186/1471-2288-14-135. View

Sarullo F, Gristina T, Brusca I, Milia S, Raimondi R, Sajeva M . Effect of physical training on exercise capacity, gas exchange and N-terminal pro-brain natriuretic peptide levels in patients with chronic heart failure. Eur J Cardiovasc Prev Rehabil. 2006; 13(5):812-7. DOI: 10.1097/01.hjr.0000238396.42718.61. View

Eleuteri E, Mezzani A, Di Stefano A, Vallese D, Gnemmi I, Delle Donne L . Aerobic training and angiogenesis activation in patients with stable chronic heart failure: a preliminary report. Biomarkers. 2013; 18(5):418-24. DOI: 10.3109/1354750X.2013.805342. View

Parrinello G, Torres D, Paterna S, Di Pasquale P, Trapanese C, Licata G . Short-term walking physical training and changes in body hydration status, B-type natriuretic peptide and C-reactive protein levels in compensated congestive heart failure. Int J Cardiol. 2009; 144(1):97-100. DOI: 10.1016/j.ijcard.2008.12.130. View

10.

Cattadori G, Segurini C, Picozzi A, Padeletti L, Anza C . Exercise and heart failure: an update. ESC Heart Fail. 2017; 5(2):222-232. PMC: 5880674. DOI: 10.1002/ehf2.12225. View

11.

Smart N, Steele M . Systematic review of the effect of aerobic and resistance exercise training on systemic brain natriuretic peptide (BNP) and N-terminal BNP expression in heart failure patients. Int J Cardiol. 2009; 140(3):260-5. DOI: 10.1016/j.ijcard.2009.07.004. View

12.

Rodseth R, Biccard B, Le Manach Y, Sessler D, Lurati Buse G, Thabane L . The prognostic value of pre-operative and post-operative B-type natriuretic peptides in patients undergoing noncardiac surgery: B-type natriuretic peptide and N-terminal fragment of pro-B-type natriuretic peptide: a systematic review and individual.... J Am Coll Cardiol. 2013; 63(2):170-80. DOI: 10.1016/j.jacc.2013.08.1630. View

13.

Vermillion S, James A, Dorrell R, Brubaker P, Mihalko S, Hill A . Preoperative exercise therapy for gastrointestinal cancer patients: a systematic review. Syst Rev. 2018; 7(1):103. PMC: 6058356. DOI: 10.1186/s13643-018-0771-0. View

14.

Stevens A, Hansen D, Herbots L, Wens I, Creemers A, Dendale P . Exercise training improves insulin release during glucose tolerance testing in stable chronic heart failure patients. J Cardiopulm Rehabil Prev. 2014; 35(1):37-46. DOI: 10.1097/HCR.0000000000000092. View

15.

Kobayashi N, Tsuruya Y, Iwasawa T, Ikeda N, Hashimoto S, Yasu T . Exercise training in patients with chronic heart failure improves endothelial function predominantly in the trained extremities. Circ J. 2003; 67(6):505-10. DOI: 10.1253/circj.67.505. View

16.

Meyer T, Schwaab B, Gorge G, Scharhag J, Herrmann M, Kindermann W . Can serum NT-proBNP detect changes of functional capacity in patients with chronic heart failure?. Z Kardiol. 2004; 93(7):540-5. DOI: 10.1007/s00392-004-0095-z. View

17.

Ahmad T, Fiuzat M, Mark D, Neely B, Neely M, Kraus W . The effects of exercise on cardiovascular biomarkers in patients with chronic heart failure. Am Heart J. 2014; 167(2):193-202.e1. PMC: 3899586. DOI: 10.1016/j.ahj.2013.10.018. View

18.

Sandri M, Kozarez I, Adams V, Mangner N, Hollriegel R, Erbs S . Age-related effects of exercise training on diastolic function in heart failure with reduced ejection fraction: the Leipzig Exercise Intervention in Chronic Heart Failure and Aging (LEICA) Diastolic Dysfunction Study. Eur Heart J. 2012; 33(14):1758-68. DOI: 10.1093/eurheartj/ehr469. View

19.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009; 339:b2535. PMC: 2714657. DOI: 10.1136/bmj.b2535. View

20.

Pearson M, King N, Smart N . Effect of exercise therapy on established and emerging circulating biomarkers in patients with heart failure: a systematic review and meta-analysis. Open Heart. 2018; 5(2):e000819. PMC: 6045761. DOI: 10.1136/openhrt-2018-000819. View