Cardiovascular Pharmacology: Open Access

The differences in lactate acid levels before and after submaximal test in reduced stable chronic heart failure

Joint Event on Heart Failure, Pediatric Cardiology & Nursing Education

February 18-19, 2019 | Amsterdam, Netherlands

Tengku Budiansyah, M Rizki Akbar and Erwinanto

Indonesia

Posters & Accepted Abstracts: Cardiovasc Pharm Open Access

Abstract:

Introduction & Aim: Heart failure is one of the main causes of morbidity and mortality worldwide. Impaired heart function results in a decrease in ventricular ejection fraction during systole and results in a decrease in cardiac output (CO). These conditions cause tissue hypoxia and promote anaerobic metabolism and cause lactate buildup. Heart failure patients also experience a decrease in capacity for physical activity. This study aims to analyze differences in lactic acid levels before and after the submaximal test (6-minute walk test) in patients with chronic heart failure with a decrease in ejection fraction.

Methods: A cross-sectional study was carried out in patients with heart failure with an ejection fraction below 40% at Dr. Hasan Sadikin General Hospital Bandung and Cibabat Regional Public Hospital from July to August 2018. Sampling was done consecutively to meet the minimum sample size. All subjects took a 6-minute walk test and measured lactate levels in the blood before and after the test. Statistical analysis used paired t-test to determine the comparison of lactate levels after a 6-minute walk test on the subject of the study.

Results & Discussion: This study involved 30 subjects, whose ejection fraction <40% (p-value <0.001) analyzed using paired t-test showed significant result that there is an increase of lactate around 44.8% after submaximal exercise with p-value less than 0.001 revealing the significantly increased level of lactate. A sub group analysis conducted, after being classified based on the level of severity of ejection fraction, the corelation of lactate level difference. It occurred at an increased lactate level with pre-test and post-test (2.38±0.64 Vs 3.72±0.91 mmol/L), around 1.34±1.00 (56.3%) in subgroup I (EF <30%). On the other hand, an increased lactate level with pre-test and post-test (2.01±0.28 Vs 2.68±0.36 mmol/L), around 0.68±0.40 (33.3%) in subgroup II (EF 30%-40%) with a p-value of 0.001 in both the subgroups. The increase in lactate levels after the 6-minute walk test was thought to be influenced by hypoxic conditions and decreased anaerobic threshold in heart failure patients.

Conclusion: There were differences in lactate levels in the blood before and after the 6-minute walk test in patients with chronic heart failure with a decrease in ejection fraction.