Abstract 20813: Improved Coronary Microvascular Function in Overweight Patients With Coronary Artery Disease Obtained After 12 Weeks of Aerobic Interval Training or Low Energy Diet is Not Maintained After 1 Year: Results From the Randomized Trial Cut-It

Introduction: Impaired coronary microvascular function in terms of low coronary flow velocity reserve (CFVR) carries a poor prognosis and is prevalent in coronary artery disease (CAD) and obesity. CFVR can be improved in overweight and obese patients by aerobic interval training (AIT) or weight loss by low energy diet (LED), however, lifestyle changes and attained benefits are difficult to sustain. We examined whether improved coronary microvascular function measured as CFVR could be maintained one year after initiating AIT or LED. Methods: Seventy, non-diabetic, stable and revascularized CAD patients with BMI 28-40 kg/m2 and age 45-75 years were randomized (1:1) to 1) 12 weeks’ AIT (16 min at 90% of peak heart rate) three times/week followed by 40 weeks’ AIT twice weekly or 2) an LED (800-1000 kcal/day) for 8-10 weeks followed by a weight maintenance diet and AIT twice weekly. CFVR was the primary outcome and assessed by transthoracic echocardiography as the ratio between pulsed wave Doppler measured coronary flow velocity of the LAD during adenosine induced myocardial hyperemia and rest. Aerobic exercise capacity (VO2peak) was measured by indirect-calorimetry and corrected for dual-energy X-ray absorptiometry (DEXA) estimated fat free body mass (FFM). Statistical analyses were performed using mixed-model ANOVA with repeated measurements. Results: Twenty-six (74%) AIT and 25 (71%) LED+AIT participants completed the one-year intervention with valid CFVR measurements. Forty-one (80%) were male, mean age 63 (6.4) years, median BMI 31.3 kg/m2 (inter-quartile-range 29.6-33.5) and VO2peak 20.7 (4.9) mL/kg. Effects on body weight and body composition, VO2peak and CFVR are given in the table. Conclusion: Despite improved body composition and significant weight loss, the improvements in coronary microvascular function obtained after 12 weeks of intervention were not maintained to the one-year follow-up. ![][1] [1]: /embed/graphic-1.gif