N terminal prohormone of brain natriuretic peptide is associated with improved heart rate recovery after treadmill exercise test

Background: Heart rate recovery (HRR) and N terminal-pro B type natriuretic peptide (NT-proBNP) are markers for survival and cardiac function; however, Little is known about their association. Method: We examined 2540 healthy subjects aged 12-49 years with data from National Health and Nutrition Examination Survey(NHANES) 1999-2002. HRR parameters 1-3 min after exercise were calculated from exercise test results. Baseline characteristics, anthropometric and NT-proBNP, and other risk covariates were obtained. Result: The results showed that NT-proBNP was positively correlated with HRR2(correlation coefficient (cc) = 0.042 [0.029-0.054], P < 0.001) and HRR3(cc = 0.046 [0.029-0.064], P = 0.001); with further adjustment, the associations remained significant between NT-proBNP and HRR2(cc = 0.030 [0.010-0.049], P = 0.004)/HRR3(cc = 0.029[0.004-0.054], P = 0.025). Our study also found significant correlations between NT-pro BNP and SBP(cc = -0.026 [-0.046∼-0.005], P = 0.017), DBP(cc = -0.037 [-0.062∼-0.012], P = 0.005), and total cholesterol(cc = -0.065 [-0.12∼-0.018], P = 0.009). Conclusions: Our results suggest that BNP might reduce heart rate after exercise by inhibiting the sympathetic nervous system (SNS), reducing HRR2 and HRR3, as these phases involve the reduction of heart rate through cardiac sympathetic withdrawal. Moreover, the interaction of BNP on the SNS might be related to the effect of BNP on cardiovascular risks.