N-terminal pro-atrial natriuretic peptide response to acute exercise in depressed patients and healthy controls

SummaryBackgroundThe dysfunction of hypothalamic–pituitary–adrenal (HPA) axis in major depression includes hyperactivity and reduced feedback inhibition. Atrial natriuretic peptide (ANP) is able to reduce the HPA-axis response to stress and has an anxiolytic effect in rodents and humans. We hypothesized that patients with depression would have an attenuated N-terminal proANP (NT-proANP) response to acute exercise compared to healthy controls. Secondly, we aimed to assess the effect of antidepressants on NT-proANP response to acute exercise.MethodsWe examined 132 outpatients with mild to moderate depression (ICD-10) and 44 healthy controls, group matched for age, sex, and BMI. We used an incremental bicycle ergometer test as a physical stressor. Blood samples were drawn at rest, at exhaustion, and 15, 30, and 60 min post-exercise.ResultsThe NT-proANP response to physical exercise differed between depressed subjects and healthy controls (group × time; F4,162.9 = 10.92; p < 0.001). The increase from rest to VO2max was 0.98 (SD 0.8) and 1.96 nmol/l (SD 1.1), respectively, for depressed subjects and healthy controls (mean diff: 0.98 nmol/l; 95% CI 0.7–1.3; t = 6.63; df = 170; p < 0.001). The increase in NT-proANP from rest to peak VO2max was 1.27 (SD 1.0) and 0.84 nmol/l (SD 0.6), respectively, for unmedicated and medicated patients (mean diff: 0.42 nmol/l; 95% CI 0.1–0.8; t = 2.56; df = 128; p = 0.01).ConclusionWe observed an attenuated NT-proANP response to acute physical stress in depressed patients. Antidepressants were associated with an independent suppressive effect on the NT-proANP response.