S126 EuroPRevent Congress Abstracts May 2015
Poster Session IV Friday, 15 May 2015, 14:00–18:00 P577 Adaptation to interval hypoxia-hyperoxia improves exercise tolerance and cardiometabolic profile in patients with coronary artery diseases
infection surveillance after discharge from the cardiac surgery department.
O Oleg Glazachev1, F Kopylov1, E Zagaynaya1, E Dudnik1 I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
Topic: Cardiac rehabilitation Background: Cardiac rehabilitation is an important component of complex treatment in stable CAD patients. It is generally known exercise-based cardiac rehabilitation is effective in reducing total and CV mortality, morbidity progression and hospital admissions. In our study we use normobaric intermittent hypoxic-hyperoxic training (IHHT) as a new alternative cardioprotective technique, experimentally proved and introduced in our pilot studies (2011-2013). Methods: From September 2011 to October 2014 we enrolled 46 patients with CAD, class IIIII, Canadian Cardiovascular Society (18 men, 28 women; 63,68,7 years, 16 with prior MI) randomly divided to receive 15 sessions of IHHT (IHHT group, n=27) and to breath with the same machine by normoxic gas mixture (placebo group, n=19) in 3 weeks. For IHHT group each breathing session consisted of 5-7 hypoxic periods (12-10% oxygen, 46 min) with 3-min hyperoxic (35% oxygen) intervals. Duration of hypoxic and hyperoxic episodes was set up following the results of hypoxic test (on a feed-back principle from SaO2 min, ReOxy Cardio device). Controls inhaled normoxic air only via the same facial mask. Study participants were advised not to change medications, nutrition and levels of physical activity during the study period. Cardiopulmonary exercise test on treadmill (peak VO2, METs, time to fatigue, anaerobic threshold AT), EchoCG, ECG, blood and biochemical determinations were performed for all patients 2-3 days before IHHT course, 2-3 days after and 30 days later IHHT program. Results: At the study beginning demographic characteristics and prevalence of risk factors were similar in both groups. After 3 weeks of breathing program in patients of IHHT group peak VO2 and AT increased signiﬁcantly already after (p=0,027, p=0,036) and 1 month after IHHT completion (p=0,019, p=0,011). No changes have been revealed in controls. Improved exercise tolerance and aerobic capacity in IHHT group were accompanied with signiﬁcant hypotensive effects (stable decrease of SBP and DBP), decrease of total cholesterol level, triglycerides, mild reticulocytosis, positive dynamics in myocardial contractile function (EchoCG), signiﬁcant improvements in all scales of Seattle Angina Questionnaire. Conclusion: Normobaric intermittent hypoxic-hyperoxic training might increased exercise tolerance reducing cardio-metabolic risk-factors in patients with stable CAD and can be useful in cardiac rehabilitation. Further studies are needed to determine the inﬂuence of IHHT on MACE and to compare IHHT with exercise-based cardiac rehabilitation. P578 Poor functional status after cardiac surgery in adult is the major predictor of infections occurring during rehabilitation
M Pistono1, C Claudio Marcassa1, R Maserati2, P Giannuzzi1 Salvatore Maugeri Foundation, IRCCS, Division of Cardiology Rehabilitation, Veruno, Italy, 2 Policlinic Foundation San Matteo IRCCS, Dept. of Infectious Disease, Pavia, Italy
Topic: Cardiac rehabilitation Background: Few data assessed the incidence of infections after discharge, particularly during an early rehabilitation phase. Aim: To assess the predictors and epidemiology of infections occurring after cardiac surgery. Methods: Data prospectively recorded from 5464 patients consecutively included in a residential cardiac rehabilitation program after cardiac surgery were retrospectively analyzed. Major infections were arbitrarily deﬁned as 1) demonstration of bacterial growth in a sample collected to rule out a clinical suspected infection and 2) requiring an intravenous antibiotic treatment. Infections were grouped as 1) surgery-site infections (SSI), and 2) healthcare associated infections (HCAI). Results: Major infections occurred in 10.9% of patients, with SSI documented in 4.1% and HCAI in 6.8% of patients. In 50% of the cases, infections were diagnosed within 4 days from admission, 1816 days from intervention. At multinomial logistic regression analysis, a Barthel index