Background: Hypertension is diagnosed in approximately 50% of patients with acute myocardial infarction. Urotensin II (U-II) - a potent vasoactive peptide shown to be elevated in hypertensive subjects, can contribute to negative myocardial remodelling and development of left ventricular failure. Data concerning U-II activity under exercise conditions and its influence on blood pressure in patients after myocardial infarction is scant. Therefore we sought to determine U-II dynamics during exercise in myocardial infarction survivors with and without hypertension.
Methods: Forty patients with acute myocardial infarction treated with successful primary coronary angioplasty, after four weeks of uneventful and symptom-free period following initial hospitalization underwent treadmill exercise test. U-II plasma concentration was measured before and shortly after the exercise.
Results: Hypertension was diagnosed in 17 (42.5%) patients. We found no significant differences between normotensive and hypertensive subjects except higher smoking rate and lower calcium channel blockers prescription in normotensive patients. Both systolic and diastolic blood pressure were comparable between study groups before exercise. After exercise we observed higher systolic blood pressure in hypertensive subjects (169.06 +/- 30.23 vs. 150.0 +/- 18.97 mm Hg; p < 0.05). U-II concentration showed no significant difference in pretest sampling (54.93 +/- 38.11 vs. 73.97 +/- 48.52 ng/ml; p = NS). After exercise we noted significantly higher peptide level in hypertensive patients (63.32 +/- 36.11 vs. 98.03 +/- 40.47 ng/ml; p = 0.01).
Conclusions: The present study is the first one to show differences in U-II concentration exercise dynamics in hypertensive and normotensive myocardial infarction survivors. It sheds additional light on hypertension pathophysiology in myocardial infarction patients, and thus identifies a novel, potentially relevant, target for future therapeutic interventions.