Endurance exercise training attenuates natriuretic peptide release during maximal effort exercise: Biochemical correlates of the “athlete’s heart”

Ankit B. Shah, Jodi Zilinski, Marcel Brown, Jennifer H. Neary, Rory B. Weiner, Adolph M. Hutter, Fred S. Apple, Michael H. Picard, James L. Januzzi, Aaron L. Baggish

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Endurance exercise training (ET) stimulates eccentric left ventricular hypertrophy (LVH) with left atrial dilation. To date, the biochemical correlates of exercise-induced cardiac remodeling (EICR) remain incompletely understood. Collegiate male rowers (n = 9) were studied with echocardiography and maximal-effort cardiopulmonary exercise testing (MECPET) before and after 90 days of ET intensification. Midregional proatrial natriuretic peptide (MR-proANP), NH2-terminal pro B-type natriuretic peptide (NT-proBNP), and high-sensitivity troponin T were measured at rest, peak MECPET, and 60 min post-MECPET at both study time points. Endurance exercise training resulted in eccentric LVH (LV mass = 102 ± 8 vs. 110 ± 11 g/m2, P = 0.001; relative wall thickness = 0.36 ± 0.04 vs. 0.37 ± 0.04, P = 0.103), left atrial dilation (74 ± 18 vs. 84 ± 15 ml, P < 0.001), and increased exercise capacity (peak Vo2 = 53.0 ± 5.9 vs. 67.3 ± 8.2 ml·kg-1·min-1, P < 0.001). Left ventricular remodeling was characterized by an ~7% increase in LV wall thickness but only a 3% increase in LV chamber radius. The magnitude of natriuretic peptide release, examined as percent change from rest to peak exercise, was significantly lower for both MR-proANP (115 [95,127]% vs. 78 [59,87]%, P = 0.04) and NT-proBNP (46 [31,70]% vs. 27 [25,37]%, P = 0.02) after ET. Rowing-based ET and corollary EICR appear to result in an attenuated natriuretic peptide response to maximal effort exercise. This may occur as a function of decreased cardiac wall stress after ET as seen by disproportionally higher ventricular wall thickening compared with chamber dilation.

Original languageEnglish (US)
Pages (from-to)1702-1709
Number of pages8
JournalJournal of applied physiology
Issue number6
StatePublished - Dec 2018
Externally publishedYes

Bibliographical note

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Copyright © 2018 the American Physiological Society. All rights reserved.


  • Athletic heart
  • Endurance exercise
  • Exercise-induced cardiac remodeling
  • Natriuretic peptides


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