P167 Acute Exercise Effects on Vascular and Autonomic Function in Patients with Stable Coronary Artery Disease

Abstract

Purpose

To examine the acute effect of maximal exercise effort on pulse wave velocity (PWV) and heart rate variability (HRV) in patients with CAD with a range of functional capacity levels, and the association between these parameters 1,2,3.

Methods

Thirty-six patients with CAD (62 ± 10 y) ranging in very-poor (5.22 ± 0.83METs; n = 18; VPFIT-CAD) to poor (6.50 ± 1.35METs; n = 18; PFIT-CAD) functional capacity, and 18 age-sex-matched healthy controls (8.53 ± 1.84METs; FFIT-CON) had their aortic- and peripheral-PWV, and HRV assessed prior to, and at 10 min and 30 min following a maximal cycle-ergometer test.

Results

Aortic- and peripheral-PWV did not differ between groups (p > 0.05) at baseline. Aortic-PWV was significantly increased at 10 min (0.63–0.98 m.s⁻¹) following exercise in all groups, but only remained so at 30 min in PFIT-CAD. Lower limb-PWV decreased in VPFIT-CAD and FFITCON at 10min (0.48; 0.51 m.s⁻¹) and remained so at 30 min (0.51; 0.45 m.s⁻¹), but not in PFIT-CAD. Still, no interaction effects were observed (p = 0.864). RMSSD was lower in PFIT-CAD compared to FFIT-CON (6.55, p = 0.009). RMSSD decreased at 10min following exercise in PFIT-CAD (5.26, p = 0.005) and FFIT-CON (8.86, p < 0.001) but only remained so at 30min in PFIT-CAD (3.27, p = 0.47; p-interaction = 0.001). A significant correlation between changes in aortic-PWV and RMSSD assessed from prior to 10min recovery was observed in VPFIT-CAD (r = 0.44, p = 0.034).

Conclusion

Patients with CAD have similar arterial response to maximal exercise compared to their higher fit healthy peers. However, HRV following exercise is apparently compromised in CAD patients. The reduction in aortic PWV is parallel to the changes in HRV in patients with CAD with very-poor functional levels.