N-terminal proB-type natriuretic peptide (NT-proBNP) concentrations in elite rugby players at rest and after active and passive recovery following strenuous training sessions

BACKGROUND: The serum biomarker N-terminal proB-type natriuretic peptide (NT-proBNP), a cleaved fragment of the brain natriuretic peptide (BNP) precursor (amino acids 1-76), is accepted as a standard marker for evaluating and monitoring cardiac injury characterized by myocardial wall stress. Strenuous exercise may generate transitory ischemia, myocardial stress and diastolic left ventricular dysfunction, possibly inducing increased concentrations of NT-proBNP. A purported caveat to prolonged strenuous exercise is based on evidence for biochemical and structural signs of heart dysfunction in recreational athletes after continuous exertion. METHODS: We compared NT-proBNP levels in three groups of physically fit subjects: top-level rugby players, professional soccer players and healthy controls. NT-proBNP concentrations were measured at rest and after an intensive training session followed by two different recovery strategies (passive or active). RESULTS: A comparison of the three samples showed that NT-proBNP concentrations in the rugby players were lower than those in controls at rest and were similar to those in professional soccer players. Elevated post-training NT-proBNP levels were unaffected by the type of recovery. The relatively high NT-proBNP levels after active recovery when psychophysical stress is higher, because of cycling and cold water immersion, suggest that not only endurance exercise, but also strenuous, stressful short exercise can induce an increase in NT-proBNP concentrations. CONCLUSIONS: In this sample of professional athletes, NT-proBNP was low at rest, and the increase after physical exercise was physiological.