BACKGROUND: The inactive N-terminal pro-BNP (NT-proBNP) serves as a marker of heart failure. We evaluated the effects of moderate exercise on NT-proBNP and other cardiovascular disease risk factors in 359 consecutive patients admitted for residential cardiovascular rehabilitation. METHODS AND RESULTS: Patients underwent cycle ergometry, blood sampling, and fasting glucose tests at the beginning and end of 25+/-4 days of the exercise program. Maximal oxygen uptake (VO2max) was estimated from the maximal watts achieved. The program consisted of cycling for 17+/-4 min, 6 times/week, and daily walking for 45 min at intensity of 60-70% of the individual maximal heart rate (HR). Patients underwent echocardiographic examination and were categorized according to left ventricular ejection fraction. NT-proBNP decreased to 29% (P = 0.001) for entire group after training. Maximal performance and VO2max improved significantly (P = 0.001). NT-proBNP was inversely related to pulse pressure at maximal exercise (-0.39), HR range (-0.35), and HR recovery in 1 min (-0.28). CONCLUSION: Four weeks of exercise reduced NT-proBNP, independent of left ventricular ejection fraction, and improved physical fitness and blood lipid profiles. NT-proBNP as a prognostic biomarker of heart failure patients was reduced and was inversely related to maximal performance and VO2max.
