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Alpha-melanocyte-stimulating hormone during exercise recovery has prognostic value for coronary artery disease

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Abstract

Purpose

Alpha-melanocyte-stimulating hormone (alpha-MSH) has proven cardiovascular effects and plays a significant role as an endogenous countermeasure to ischemia-reperfusion injury. The aim of the current study was to examine the response of alpha-MSH during exercise in patients diagnosed with coronary artery disease (CAD) and evaluate its value in the assessment of severity and prognosis.

Methods

Forty subjects with documented CAD (i.e., lesions on coronary angiography ≥ 50%) were included. Cardiopulmonary exercise testing (CPET) on a treadmill (TM) and recumbent ergometer (RE) were performed on two visits, 2–4 days apart, during 2 months of coronary angiography; subsequently, the subjects were followed up for 32 ± 10 months. At rest, at peak CPET, and after 3 min of recovery, plasma levels of alpha-MSH were measured by enzyme-linked immunosorbent assay technique.

Results

Mean ejection fraction was 56.7 ± 9.6%. Alpha-MSH similarly increased from rest to peak CPET on both modalities. There were no significant differences in alpha-MSH values during testing in patients with 1,2- and 3-vesel CAD, nor in patients with a SYNTAX score </≥ 23 (p > 0.05). Among CPET and hormonal parameters, ∆alpha-MSH recovery/peak during RE CPET was the best predictor of cardiac event occurrence (chi-square 6.67, HR = 0.51, CI = 0.25–1.02, p = 0.010).

Conclusion

∆alpha-MSH recovery/peak during RE CPET has predictive value for CAD prognosis, demonstrating involvement of alpha-MSH in CAD and a link between stress hormones and cardiac events.

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Abbreviations

CABG:

Coronary artery bypass graft

CAD:

Coronary artery disease

CPET:

Cardiopulmonary exercise test

EF:

Left ventricular ejection fraction,

HR:

Heart rate

MI:

Myocardial infarction

MSH:

Melanocyte-stimulating hormone

SCA:

Number of stenotic coronary arteries

O2 pulse:

Oxygen pulse

PCI:

Percutaneous coronary intervention

RE:

Recumbent ergometer

RER:

Respiratory exchange ratio

VCO2 :

Carbon dioxide output

VE:

Ventilation

VO2 :

Oxygen consumption

∆VO2/∆WR:

Work efficiency

WR:

Work rate

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Funding

The study is supported by Projects Number iii 41022 and 175036 Ministry of Education, Science and Technological Development.

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Authors and Affiliations

  1. Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11000, Serbia

    Dejana Vidojevic, Marija Saric Matutinovic, Snezana Jovicic, Svetlana Ignjatovic & Dejana Popovic

  2. Faculty of Sport and Physical Education, Balgoja Parovica 156, Belgrade, 11000, Serbia

    Stefan Seman

  3. Division of Cardiology, University of Belgrade, Visegradska 26, Belgrade, 11000, Serbia

    Ratko Lasica, Milorad Tesic & Dejana Popovic

  4. Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA

    Ross Arena

  5. Division of Endocrinology, Clinical Center of Serbia, University of Belgrade, Dr Subotica 13, Belgrade, 11000, Serbia

    Svetozar Damjanovic

Authors
  1. Dejana Vidojevic
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  2. Stefan Seman
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  10. Dejana Popovic
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Correspondence to Dejana Popovic.

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The publication of this manuscript has been approved by all coauthors and responsible authorities from the University Clinical Center Serbia where the work has been carried out. The local Ethical Committee approved the study.

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All participants provided written informed consent for participation in the study.

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Vidojevic, D., Seman, S., Lasica, R. et al. Alpha-melanocyte-stimulating hormone during exercise recovery has prognostic value for coronary artery disease. Hormones 20, 381–387 (2021). https://doi.org/10.1007/s42000-020-00270-2

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