Cardiovascular Journal of Africa: Vol 22 No 2 (March/April 2011) - page 34

CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 2, March/April 2011
88
AFRICA
ing were due to elevated cardiac load and increased ventricular
wall tension.
38,39
The most important limitation of our study was the small
number of patients. This was due to us excluding patients with
known coronary artery disease and prior revascularisation.
Another limitation was that it was a single-centred study reflect-
ing a local area.
Conclusion
In our study we found that there was no relationship between
exercise-induced transient myocardial ischaemia and serum
hs-CRP and SAA levels as inflammatory biomarkers, and serum
NT-proBNP levels as a non-inflammatory biomarker. All three
biomarkers increased with exercise for different reasons but
these elevations were not related to transient myocardial ischae-
mia. Large-scale clinical studies are needed to clarify the status
of hs-CRP, SAA and NT-proBNP with exercise.
References
1. Pepys M, Hirschfield G. C-reactive protein: a critical update.
J Clin
Invest
2003;
111
: 1805–1812.
2. Calabro P, Willerson J, Yeh E. Inflammatory cytokine stimulate
C-reactive protein production by human coronary artery smooth muscle
cells.
Circulation
2003;
108
: 1930–1932.
3. Biasucci LM, Liuzzo G, Grillo RL, Caligiuri G, Rebuzzi AG, Buffon
A,
et al
. Elevated levels of C-reactive protein at discharge in patients
with unstable angina predict recurrent instability.
Circulation
1999;
99
:
855–860.
4. Lindahl B, Toss H, Siegbahn A, Venge P. Wallentin L. Markers of
myocardial damage and inflammation in relation to long-term mortal-
ity in unstable coronary artery disease.
N Engl J Med
2000;
343
:
1139–1147.
5. Tanaka A, Shimada K, Sano T, Namba M, Sakamoto T, Nishida Y,
et
al
. Multiple plaque rupture and C-reactive protein in acute myocardial
infarction.
J Am Coll Cardiol
2005;
45
: 594–599.
6. Cosin-Sales J, Pizzi C, Brown S, Kaski JC. C-reactive protein, clini-
cal presentation, and ischemic activity in patients with chest pain and
normal coronary angiograms.
J Am Coll Cardiol
2003;
41
:1468–1474.
7. Shehadeh J, Lewis BS, Weisz G, David M, Ashkenazi T, Halon DA.
Relation between C-reactive protein, treadmill exercise testing, and
inducible myocardial ischemia.
Am J Cardiol
2004;
93
: 614
617.
8. Veselka J, Procházková S, Duchonová R, Bolomová I, Urbanová T, Tesar
D, Honek T. Relationship of C-reactive protein to presence and severity
of coronary atherosclerosis in patients with stable angina pectoris or a
pathological exercise test.
Coron Art Dis
2002;
13
: 151
154.
9. Uhlar CM, Whitehead AS. Serum amyloid A, the major vertebrate
acute-phase reactant.
Eur J Biochem
1999;
265
: 501
523.
10. Ebeling P, Teppo AM, Koistinen HA, Viikari J, Rönnemaa T, Nissén M,
et al
. Troglitazone reduces hyperglycaemia and selectively acute-phase
serum proteins in patients with type II diabetes.
Diabetologia
1999;
42
:
1433
1438.
11. Leinonen ES, Hiukka A, Hurt-Camejo E, Wiklund O, Sarna SS, Mattson
Hultén L,
et al
. Low-grade inflammation, endothelial activation and
carotid intima-media thickness in type 2 diabetes.
J Intern Med
2004;
256
: 119
127.
12. Kontush A, Chapman J. Functionally defective high-density lipoprotein:
A new therapeutic target at the crossroads of dyslipidemia, inflamma-
tion, and atherosclerosis.
Pharmacol Rev
2006;
58
: 342–374.
13. Johnson BD, Kip KE, Marroquin OC, Ridker PM, Kelsey SF, Shaw
LJ,
et al;
National Heart, Lung and Blood Institute. Serum amyloid A
as a predictor of coronary artery disease and cardiovascular outcome
in women: the National Heart, Lung and Blood Institute-sponsored
Women’s Ischemia Syndrome Evaluation (WISE).
Circulation
2004;
109
: 726
732.
14. Kosuge M, Ebina T, Ishikawa T,
et al
. Serum amyloid A is a better
predictor of clinical outcomes than C-reactive protein in non-ST-
segment elevation acute coronary syndromes.
Circ J
2007;
71
: 186–190.
15. Soeki T, Kishimoto I, Okumura H, Tokudome T, Horio T, Mori K,
Kangawa K. C-type natriuretic peptide, a novel antifibrotic and antihy-
pertrophic agent, prevents cardiac remodeling after myocardial infarc-
tion
. J Am Coll Cardiol
2005;
45
: 608–616.
16. Weber M, Mitrovic V, Hamm C. B-type natriuretic peptide and
N-terminal pro-B-type natriuretic peptide: Diagnostic role in stable
coronary artery disease.
Exp Clin Cardiol
2006;
11
: 99–101.
17. Tóth M, Vuorinen KH, Vuolteenaho O, Hassinen IE, Uusimaa PA,
Leppäluoto J, Ruskoaho H. Hypoxia stimulates release of ANP and BNP
from perfused rat ventricular myocardium.
Am J Physiol Heart Circ
Physiol
1994;
266
: 1572–1580.
18. Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF,
Froelicher VF,
et al
; American College of Cardiology/American Heart
Association Task Force on Practice Guidelines (committee to update
the 1997 Exercise Testing Guidelines). ACC/AHA 2002 guideline
update for exercise testing: summary article: a report of the American
College of Cardiology/American Heart Association Task Force on
Practice Guidelines (Committee to Update the 1997 Exercise Testing
Guidelines).
Circulation
2002;
106
: 1883–1892.
19. Chait A, Han CY, Oram JF, Heinecke JW. Lipoprotein-associated
inflammatory proteins: markers or mediators of cardiovascular disease
?
J Lipid Res
2005;
46
: 389
403.
20. Van der Westhuyzen DR, de Beer FC, Webb NR. HDL cholesterol
transport during inflammation.
Curr Opin Lipidol
2007;
18
: 147
151.
21. Kisilevsky R, Tam SP. Acute phase serum amyloıd a, cholesterol
metabolısm, and cardiovascular disease.
Pediat Pathol Mol Med
2002;
21
: 291
305.
22. Ogasawara K, Mashiba S, Wada Y, Sahara M, Uchida K, Aizawa T,
Kodama T. A serum amyloid A and LDL complex as a new prognostic
marker in stable coronary artery disease.
Atherosclerosis
2004;
174
:
349
356.
23. Shephard RJ, Shek PN. Potential impact of physical activity and sport on
the immune system : A brief review.
Br J Sp Med
1994;
28
: 247–255.
24. Fischer CP. Interleukin-6 in acute exercise and training: what is the
biological relevance?
Exer Immunol Rev
2006;
12
: 6–33.
25. Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE,
Duc P,
et al
; Breathing Not Properly Multinational Study Investigators.
Rapid measurement of B-type natriuretic peptide in the emergency diag-
nosis of heart failure.
N Engl J Med
2002;
347
: 161–167.
26. Harrison A, Morrison LK, Krishnaswamy P, Kazanegra R, Clopton P,
Dao Q,
et al
. B-type natriuretic peptide (BNP) predicts future cardiac
events in patients presenting to the emergency department with dyspnea.
Ann Emerg Med
2002;
39
: 131–138.
27. Chang AY, Abdullah SM, Jain T, Stanek HG, Das SR, McGuire DK,
et al
. Associations among androgens, estrogens, and natriuretic peptides
in young women: observations from the Dallas Heart Study.
J Am Coll
Cardiol
2007;
49
: 109–116.
28. Bibbins-Domingo K, Ansari M, Schiller NB, Massie B, Whooley MA.
B-type natriuretic peptide and ischemia in patients with stable coronary
disease.
Circulation
2003;
108
: 2987–2992.
29. Schnabel R, Lubos E, Rupprecht HJ, Espinola-Klein C, Bickel C,
Lackner KJ,
et al
. B-type natriuretic peptide and the risk of cardiovas-
cular events and death in patients with stable angina: results from the
AtheroGene study
. J Am Coll Cardiol
2006;
47
: 552–558.
30. Kurz K, Voelker R, Zdunek D, Wergeland R, Hess G, Ivandic B,
et al
.
Effect of stress-induced reversible ischemia on serum concentrations of
ischemia-modified albumin, natriuretic peptides and placental growth
factor.
Clin Res Cardiol
2007;
96
: 152–159.
31. Staub D, Nusbaumer C, Zellweger MJ, Jonas N, Wild D, Pfisterer ME,
et al
. Use of B type natiuretic peptide in the detection of myocardial
ischemia.
Am Heart J
2006;
151
: 1223–1230.
32. Sabatine MS, Morrow DA, de Lemos JA, Omland T, Desai MY,
Tanasijevic M,
et al
. Acute changes in circulating natriuretic peptide
levels in relation to myocardial ischemia.
J Am Coll Cardiol
2004;
44
:
1988–1995.
33. Foote RS, Pearlman JD, Siegel AH, Yeo KT. Detection of exercise-
induced ischemia by changes in B-type natriuretic peptides.
J Am Coll
1...,24,25,26,27,28,29,30,31,32,33 35,36,37,38,39,40,41,42,43,44,...60
Powered by FlippingBook