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EuroPRevent Congress Abstracts May 2015

Moderated Poster Session II - Exercise Basic & Translational Research Thursday, 14 May 2015, 15:30–16:30 P67 Specific progression of ischemic heart disease in patients with diabetes mellitus type 2 under hypoglycemic conditions

AI Chesnikova1, M Maria Nichitenko1, VI Kudinov1, VP Terentyev1 State Medical University of Rostov-on-Don, Internal Diseases ? 1, Rostov-on-Don, Russian Federation

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Topic: Diabetes Aim: To study the specific progression of ischemic heart disease (IHD) in patients with diabetes mellitus type 2 (DM 2) under hypoglycemic conditions. Methods: 110 patients, divided in four groups, were observed and investigated. The main group (group A) consisted of 54 patients with IHD and DM 2 with frequently occurring hypoglycemic conditions (more than 5 times a week). For comparison, two groups were used (groups B and C). In group B, there were 18 patients with IHD and DM 2 but with rare hypoglycemic condition (less than 3 times a week). The mean duration of DM 2 in the main group was 12.74.1 years, while in the first group it was 11.22.8 years. Group C consisted of 21 patients with IHD but without DM. The control group (group D) had 17 patients without any history of cardio-vascular pathologies not diabetes. In all patients, the level of glycosylated hemoglobin (HbA1c) was investigated, data of episodes of hypoglycemia, mean number of ischemic occurrences, mean duration of daily depression and/or elevation of ST segment, frequency of occurrence of different heart rhythm disorders (HRD) and conduction data from Holter Heart Monitor were registered. Results: In group A patients with frequent hypoglycemic episodes, the level of HbA1c at 1.71% (p=0.001) was higher in comparison to group B patients. In group A, the frequency of angina was 2.7 times higher than group B patients (p=0.001), and 3.7 times higher than group C patients (p=0.0001). The most number of patients with ST depression were in group A. The mean duration of ischemic episodes in group A was 3.4 times higher than that of patients of group B (p=0.0006), and 3.5 times higher than the duration of group C patients. The frequency of ischemic episodes of group A patients was also significantly higher than group B (p=0.045) and group C (p=0.04) respectively. The most frequently registered heart rhythm disorder in group A as well as both group B and C was extrasystole arrhythmia. However, in group A, there were 10.6 times more patients with ventricular extrasystole arrhythmia (p=0.000001) and 5.3 times more patients with supraventricular extrasystole arrhythmia (p=0.03) than patients of group B. In group A patients, in 38.9% of cases, ventricular extrasystole arrhythmia with high gradation according to Lown classification were registered. Conclusion: Frequent hypoglycemic conditions in patients suffering from DM 2significantly increased the rate and severity of clinical occurrences of IHD, increased the progression of myocardial ischemia, and also significantly increased the frequency of HRD and heart conductivity. P68 Individual lactate kinetics during exercise testing can determine the prescription of the most effective training mode in patients with coronary artery disease

P J M Beckers1, W De Ridder2, N Vanhauter2, V Verhoeven2, C De Maeyer1, V Conraads1 University of Antwerp Hospital (Edegem), Antwerp, Belgium, 2University of Antwerp, Antwerp, Belgium

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Topic: Exercise training Purpose: The aim of this RCT was to investigate whether the gain in VO2peak by Aerobic Interval Training (AIT) or Aerobic Continuous Training (ACT) depends on individual lactate kinetics during a Cardiopulmonary Exercise Test (CPET) as measured before the start of the training program. Methods: 30 patients, randomly assigned to AIT or ACT, participated 3 times a week during 12 weeks in supervised training on bicycle. Training intensity was automatically adjusted according to the target training heart rate, calculated as a percentage of peak heart rate during CPET. Blood lactate at the earlobe was measured every minute during CPET at baseline, after 6 weeks and after 12 weeks. Relative time to total CPET duration of both aerobic (2mmol/L lactate) and anaerobic (4mmol/L) was calculated as minlact2 and minlact4 respectively. Correlation analysis was performed on 29 patients. Results: VO2peak increased equally in both ACT (15.82 % [SD 16.46] n=14) and AIT (26.60 % [SD 18.07], n=15) without a significant difference between both training programs; t(27)=-1.676, p=0.105. Correlation analysis in the ACT-group showed statistically significant correlation between relative increase of VO2peak and minlact2 (r=0.560, n=14, p=0.037); in the AIT-group there were statistically significant correlations between relative increase of VO2peak and minlact2 (r=-0.553, n=15, p=0.033), minlact4 (r=-0.564, n=15, p=0.028) and the interaction term of minlact2 and minlact4 (r=-0.656, n=15, p=0.008). Multiple linear regression analysis for relative increase in VO2peak with these variables in the ACTgroup showed statistically significant (p

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