Abstract 16693: The Effect of Exercise Training on Coronary Flow Velocity Reserve in Chronic Heart Failure Patients
Introduction: Exercise training improves physical function in heart failure (HF) patients, but the exact mechanisms are not fully understood. Coronary flow velocity reserve (CFVR) is a measure of microvascular function in patients without coronary artery stenosis and in HF a low CFVR is associated with a poor prognosis.
Purpose: To determine the effect of moderate continuous training (MCT) and aerobic interval training (AIT) on CFVR measured by echocardiography in HF patients
Methods: The study is a substudy to the international multicenter trial SMARTEX-HF where HF patients with LVEF < 35 were randomized to 12 weeks of AIT, MCT or recommendation of regular exercise (RRE). The first two groups exercised three times a week, while the RRE group had no training. CFVR was measured in the substudy population using a high frequency transducer. Peak coronary flow velocity (CFV) was measured in the mid-distal part of LAD at rest and during 2 minutes of adenosine stress. CFVR was the ratio between CFV at rest and during stress.
Results: A total of 31 patients completed 12 weeks of training with valid measurements of CFVR. Mean age was 68 (9.6) years, LVEF 30 (5) %, VO2peak 17.9 (5.6) ml/min/kg, CFVR 1.98 (0.8) and 20 (65%) had ischemic HF. There was no difference in change in VO2peak between the groups, also when combining the AIT and MCT groups into one training group (0.26 vs. 0.23, p=0.96). There was a trend towards a significant improvement in CFVR between the training group and the RRE group (0.28 vs. -0.27, p=0.06). In the subgroup of patients with ischemic HF the improvement was statistically significant (0.31 vs. -0.54, p=0.03).
Conclusion: Despite only modest effect on VO2peak, exercise training tended to improve CFVR in HF patients and CFVR improved significantly in patients with ischemic HF. This effect should be examined in a larger study but could be part of the overall benefit of exercise training in HF.
Figure legend: Box plot showing the difference in CFVR before and after 12 weeks.
Author Disclosures: M. Snoer: None. T. Monk-Hansen: None. R.H. Olsen: None. F. Dela: None. E. Prescott: None.
- © 2016 by American Heart Association, Inc.