ORALABST

RACTS

changes recorded during DSE is poorly established especially separately in womenand men.Objectives: To assess sensitivity, specificity, positive and negative predictive values andaccuracy of chest pain and ST segment depression above 1 mm recorded during DSE insubjects of both sexes with clinical symptoms suggesting coronary artery disease andcompare them in men and women.Methods: We examined 238 patients by DSE with atropine administration, 105 female,mean age 62�9. In the whole group after DSE the status of the coronary arteries wasevaluated in time window of three months by angiography or computed tomography. Thestenosis �50% in main left and �70% in others coronary arteries were regarded as sig-nificant. We recorded any chest pain reported by patient during dobutamine infusion orrecovery phase. The presence of ST segment depression was assessed according to 12-leadECG performed at the peak of test - immediately after discontinuation of dobutaminebecause of symptoms or heart rate limit.Results: We observed rather limited diagnostic value of isolated chest pain and ECGchanges during DSE in detection of CAD with slightly higher accuracy of chest pain.Nevertheless both parameters showed moderate, exceeding 70% negative predictive valuein women and positive predictive value in men, see table.

Table 1. Diagnostic value of chest pain and ECG changes during dobutamine stressechocardiography in the whole group and in women and men.

Parameter/diagnostic value All subjects

Women

N[105

Men

N[133

Chest pain/ECG changes

Sensitivity 58.3/59.1% 51.4/73.0% 61.1/53.3%

Specificity 64.9/51.4% 64.7/44.1% 65.1/55.8%

Positive predictive value 65.5/58.1% 44.2/41.5% 78.6/71.6%

Negative predictive value 58.1/52.3% 72.1/75.0% 44.4/36.4%

Accuracy 61.3/55.5% 60.0/54.3% 62.4/54,1%

Conclusion: Chest pain and ECG changes during DSE showed moderate and gender -dependent diagnostic utility.Disclosure of Interest: K. Wierzbowska-Drabik Grant/research support from: The StateCommittee for Scientific Research, number N N402 5002 40, K. Cygulska : None Declared,A. Budek-Sydor: None Declared, J. Kasprzak Grant/research support from: The StateCommittee for Scientific Research, number N N402 5002 40

O074

Gender differences in coronary angiographic flow in patients without obstructiveepicardial coronary artery disease undergoing coronary spasm provocation testing

David Di Fiore*1, Christopher Zeitz1, Margaret Arstall2, Abdul Sheikh1, John Beltrame11Department of Cardiology, The Queen Elizabeth Hospital, Woodville, 2Department ofCardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia

Introduction: It is speculated that differences in coronary microvascular disease existsbetween gender groups who present with chest pain without obstructive epicardial coro-nary artery disease.Objectives: To assess coronary angiographic flow indices in patients without obstructiveepicardial coronary disease undergoing Acetylcholine (ACh) coronary provocation testing.Methods: We undertook ACh provocation testing in 169 patients where no significantcoronary artery disease was found. Patients were administered escalating doses of intra-coronary ACh (25mcg, 50mcg, 100mcg) until either a positive response was achieved,defined as >90% vasoconstriction, or the maximum dose was given. TIMI Frame Count(TFC) analysis was performed on baseline images.

TIMI Frame Count (Frames) LAD LCx RCA Overall

Positive Response (N¼74)

Males 24.8+5.5 25.7+7.5 31.5+13.3 26.3+0.3

Females 26.4+10.0 N/A 30.4+12.0 28.7+11.2

P Value 0.59 N/A 0.87 0.35

Negative Response (N¼95)

Males 24.2+6.6 35.3+9.4 36.8+16.6 32.9+ 12.8

Females 23.2+7.2 31.0+12.3 26.9+9.3 27.3+10.5

P Value 0.59 0.09 <0.001 0.001

e20

Results: The 74 positive response patients (54.5 � 8.9 years; 74% females) were of similarage to the 95 negative response patients (53.1 � 10.7 years; 79% females) (p¼0.43).Differences between groups were not statistically significant apart from gender differencesin those with a negative response.Conclusion: The results suggest that males without obstructive epicardial coronary diseasehave increased resting microvascular resistance compared with females only when there is anegative response to Acetylcholine provocation. This may suggest that in the absence ofepicardial coronary artery spasm, an increased microvascular resistance in males isresponsible for their presentation with chest pain.Disclosure of Interest: None Declared

O075

Influence of high intensity training in endothelial function and oxidative stress inpatients with heart failure

Vitor G. Angarten1, Almir Schmitt Netto1, Anderson Z. Ulbrich1, Sabrina W. Sties1,Lourenço S. de Mara1, Fernanda A. Cruz1, Edson L. da Silva2, Tales de Carvalho*11Cardiology and Exercise Medicine Center, Santa Catarina State University, 2Federal Universityof Santa Catarina, Florianópolis, Brazil

Introduction: There is consensus regarding the influence of exercise on morbidity andmortality in patients with heart failure (HF), however there are doubts about the advantageof high intensity training.Objectives: Evaluate the effect of high intensity exercise on functional capacity, circulatoryoxidative stress (OS) and quality of life (QOL) in patients with high HF.Methods: Twenty patients with stable HF, randomized into 2 groups, underwent 12 weeksof exercise training, three times per week: moderate continue training (MCT) in target zoneof heart rate (HR) corresponding to anaerobic threshold (first ventilatory threshold) and inhigh-intensity training (HIT) with HR corresponding to respiratory compensation point(second ventilatory threshold) alternating with HR corresponding to anaerobic threshold(recovery period). Outcomes of study: peak oxygen consumption (VO2peak) determinedby cardiopulmonary exercise test, left ventricular ejection fraction (LVEF) and endothelialfunction (EF) (flow - mediated dilation FMD) assessed by Doppler echocardiography;superoxide dismutase (SOD) by spectrophotometry; blood pressure (BP) by auscultationmethod; QOL by Minnesota questionnaire.Results: The VO2peak increased more in HIT (HIT: 21.2 � 3.9 to 24.1 � 4.8, p¼0,000;MCT: 18.59 � 3.09 to 20.31 � 3.08, p¼0,08); LVEF increased more in HIT (HIT: 34.81 �6.86 to 39.75 � 8.1, p¼0,01; MCT: 31,29 � 7,22 to 34,51 � 10,60, p¼0,227); FMDincreased significantly in the MCT (MCT: 0”: 38,82�5,66; 60”: 39,84�5,92 to 0”:38,98�5,62; 60”: 41,78�5,10, p¼0,03; HIT: 0”: 47,65�9,26; 60”: 51,02�9,55 to 0”:47,44�7,32; 60”: 50,64�5,23, p¼0,063); SOD activity more increased with the HIT (HIT:0.30 � 0.12 to 0.51 � 0.17, p¼ 0.025; MCT: 0.36 � 0,12 to 0.42 � 0.15, p¼0,456);systolic BP decreased more in HIT (HIT: 126,50�26,15 to 111,25�17,36, p¼0,02; MCT:114,22�15,80 to 105,55�13,66, p¼0,093).Conclusion: The HIT was superior than MCT to improve functional parameters (VO2 peakand PAs) and antioxidant activity, while the MCT was superior to improve circulatoryparameter (FMD), and quality of life improved without differences in both groups.Disclosure of Interest: None Declared

O076

Functional and Structural Changes in Soccer Players and the Risk for Sudden CardiacDeath

Ayman Azoz*Cardiac Technology, University of Dammam, Dammam, Saudi Arabia

Introduction: Regular exercise in athletes is associated with cardiac acclimation in the formof functional and structural changes. Its effect on the cardiac functions still debated.Objectives: To detect the impact of long-term regular physical exercise on the cardiacsystolic and diastolic function of soccer players.Methods: Thirty professional soccer players were examined twice, the first examina-tion was made during the passive resting period before the beginning of the season(measurement I) and the second examination during the peak of the season (mea-surement II). At both examinations players underwent ECG, conventional Echo-Doppler, Pulsed TDI on both septal and lateral sides of the mitral annulus and lateraltricuspid annulus. The (Vp) values were measured. Paired t-test was used forcomparison.Results: The following changes between measurement I and measurement II werefound: The mitral E/E` ratio increased from 6.18 � 1.27 to 6.91 � 1.18; the Vpdecreased from 56.3 � 9.23 to 50.67 � 8.6; the tricuspid valve E/A ratio decreasedfrom 1.67 � 0.23 to 1.54 � 0.23 while the E`/A` ratio decreased from 1.67 � 0.53 to1.28 � 0.49; the (IVRT) of the RV increased from 52.4 � 11.33 to 58.17 � 10.73;the (IVCT) decreased from 70.47 � 9.9 to 65.2 � 7.9. All changes were statisticallysignificant at P < 0.001.

GHEART Vol 9/1S/2014 j March, 2014 j ORAL/2014 WCC Orals