Postexercise ischemia is associated with increased neuropeptide Y in patients with coronary artery disease

Citation
L. Gullestad et al., Postexercise ischemia is associated with increased neuropeptide Y in patients with coronary artery disease, CIRCULATION, 102(9), 2000, pp. 987-993
Citations number
24
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
CIRCULATION
ISSN journal
0009-7322 → ACNP
Volume
102
Issue
9
Year of publication
2000
Pages
987 - 993
Database
ISI
SICI code
0009-7322(20000829)102:9<987:PIIAWI>2.0.ZU;2-#
Abstract
Background-Neurohormones may influence Vascular tone both during and after exercise. Neuropeptide Y (NPY), which is costored and released with norepin ephrine (NE) during sympathetic activity, is a potent vasoconstrictor with a relatively long half-life. We therefore examined its possible association with the ischemic response to exercise in patients with coronary artery di sease. Methods and Results-Twenty-nine male patients with effort-induced angina pe ctoris underwent a symptom-limited exercise test. In addition to convention al ST-segment analysis, we examined ischemia on the basis of heart rate (HR )-adjusted ST-segment changes through calculation of the ST/HR slope during the final 4 minutes of exercise and of the ST/HR recovery loop after exerc ise, Blood samples were taken before, during, and after exercise for an ana lysis of several neurohormones. Mean ST-segment depression was -223+/-20.2 mu V (P<0.0001) just before the termination of exercise, followed by a grad ual normalization, but it remained significant after 10 minutes (-49+/-8.9 mu V, P<0.0001). At the end of exercise, the ST/HR slope, which reflects my ocardial ischemia, was -6.0+/-0.77 mu V/HR. In most patients, ST-segment le vels at a given HR were lower during recovery than during exercise, here re ferred to as ST "deficit." Exercise increased the plasma levels of NPY, NE, epinephrine, and N-terminal proatrial natriuretic peptide, but big endothe lin remained unchanged. Although NE and epinephrine peaked at maximal exerc ise, the highest levels of NPY and N-terminal proatrial natriuretic peptide were observed 4 minutes after exercise. The maximal increase in the NPY co rrelated significantly with ST-segment depression at 3 minutes after exerci se (r= -0.61, P=0.0005), the ST deficit at the corresponding time point (r= - 0.66, P=0.0001), and the duration of ST-segment depression after exercis e (r=0.42, P=0.02). In contrast, no such correlations were found for NE. Conclusions-The present study has for the first time demonstrated a correla tion between plasma NPY levels and the degree and duration of ST-segment de pression after exercise in patients with coronary artery disease, which sug gests that NPY may contribute to myocardial ischemia in these patients.