P3743Factors affecting the degree of reverse myocardial remodeling due to long aerobic training in heart failure patients

Abstract

To evaluate the effects of long‐term aerobic training, designed with individualized method based on lactate threshold definition, on myocardial remodeling in heart failure patients and to detect its predictors. Methods:We evaluated 197 HF patients, mean age 52±3.3, 116 men, with NYHA class III, LVEF 37,6±2,1%. CPET performed on a treadmill ( Oxycon Pro ) at baseline, in every 8 weeks and after 9 months. All patients were randomized into following groups: 137 patients of study group (SG), who underwent physical rehabilitation program (PRP), calculated due to lactate threshold; and 60 HF patients control group (CG), who underwent physical training, calculated based on VO2 percentage. Results: At baseline CPET results in both groups did not significantly differ. VO2 at lactate threshold and VO2peak were 8.8±0,5; 13,5±0,9 ml/min/kg and 9.0±0.9; 13,6±1,2 ml/min/kg in study group and control group, respectively (p1=0,08, p2=0,07, respectively). After 9 months of training VO2LT and VO2peak were better in the study group than in control group: the increase was 16% and 24% in the main group, and 4% and 7% in the control group, respectively (p1<0,01, p2<0,01). 54 pts from study group have trained every day more than 1,5 hour on their own. After 9 months of aerobic training it was significant improvement of myocardial contractile function in this 54 patients: LA, at baseline and after training were 5,5±0,1 and 5,1±0,6 sm; LVEDD 6,4±0,4 and 5,9±0,2sm; LVESD 5,9±0,3 and 5,3±0,3 sm, LVEF 33±3,7 and 46±5,5%, p<0,001. In control group patients and other 83 pts SG the improvement of myocardial contractile function was not observed: LA, at baseline and after training were 5,4±0,3 and 5,4±0,3 sm; LVEDD 6,3±0,5 and 6,3±0,2 sm; LVESD 5,9±0,5 and 5,8±0,3sm, LVEF 36±5,3 and 40,2±4,7%, p>0,05. We found correlation between LVEDD changes and duration of training (r=‐0,9, p<0,05), LVEDD changes and BMI (r=0,7, p<0,05), LVEDD changes and b‐blockers dose (r=0,4, p,0,05), LVSED changes and blood creatinine (r=‐0,4, p<0,05). Conclusions: Aerobic exercise, designed with individualized method based on lactate threshold definition, increase exercise tolerance, improves myocardial contractile function more than aerobic training, calculated based on VO2peak percentage. There are correlation between LVEDD changes and duration of training (r=‐0,9, p<0,05), LVEDD changes and BMI (r=7, p<0,05), LVEDD changes and bblockers dose (r=4, p,0,05), LVSED changes and blood creatinine (r=4, p<0,05).