CK-MB, mostly of muscle origin and reflecting labor stress or injury, is not to recommend as a measure of myocardial damage in the neonate. The rise in cTnI may be explained by a degree of myocardial involvement, albeit physiological. The initial rise and subsequent fall of NT-proBNP represents the physiological ventricular overload of transient birth adaptation.

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Funding Acknowledgements Type of funding sources: None. Introduction  Cardiovascular disease (CVD) is recognized as a major public health issue and remains the leading cause of mortality worldwide. There is a clear association between adiposity, blood lipid profile, and adherence to the Mediterranean diet (MD) with the risk of CVD. However, the assessment of body composition parameters, dietary patterns and nutritional intervention in CVD patients undergoing a cardiovascular rehabilitation (CR) program remains insufficient.  Purpose  to characterize body composition, lipid profile and MD adherence in patients with CVD who were attending an exercise-based CR program during COVID-19 era.  Methods  The study was developed between October 2020 and January 2021 in a phase III centre-based CR program. Body composition was assessed by dual energy x-ray absorptiometry Hologic Explorer-W. Adherence to the MD was assessed by the 14-item MD questionnaire. Fasting blood sample was taken for measurement of lipid profile.  Results  A sample of 41 patients (mean age 64.4 ± 7.9 years, 87.8% male) was evaluated. The most prevalent CVD were coronary artery disease (89.5%) and heart failure (21.1%). The main CVD risk factors at admission in the CR program were dyslipidaemia (71.1%), hypertension (68.4%), physical inactivity (26.3%) and diabetes mellitus (21.0%). In our sample the mean body mass index was 28 ± 3.8 kg/m2, being most patients overweight (75.6%), and having a substantially increased risk of metabolic complications (85.3%) accordingly to waist-hip ratio. Body composition assessment showed that 14.6% of the patients had a body fat mass index above 90th percentile. Although only 9.8% of the patients had reduced fat free mass, 17.1% showed appendicular lean mass below the reference value. In addition, less than one third of the patients (31.7%) revealed a high adherence to the MD pattern. A sub-analysis on blood lipids (n = 26) showed that most patients had levels of LDL cholesterol (76.9%) and non-HDL cholesterol (65.4%) above the therapeutic target and 15.4% had triglycerides higher than 150 mg/dl.  Conclusion  Body composition, lipid profile and dietary patterns, play a major role in CVD secondary prevention. Our findings showed that a substantial number of CVD patients, in COVID-19 era, did not have optimal body composition, were above lipid profile targets, and had a low/medium adherence to the MD. Thus, this study highlights the relevance of nutrition on cardiometabolic status and demonstrates the crucial role of nutritional intervention as an integrated part of a long-term phase III CR program. Moreover, further research about nutritional intervention in patients undergoing CR is warranted.

Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular rehabilitation (CR) was one of the many areas negatively affected by the COVID-19 pandemic. A high number of cardiovascular disease (CVD) patients had their centre-based program suspended. Physical activity (PA) recommendations for CVD patients are well established and its benefits largely documented. However, few studies have objectively measured the PA of these patients throughout the years and specifically during the COVID-19 pandemic.  Purpose To objectively measure PA and sedentary time (ST) during COVID-19 pandemic in comparison with the previous 2 years in CVD patients who were attending a phase III centre-based CR program.  Methods Before COVID-19, eighty-seven CVD patients (mean age 62.9 ± 9.1, 82.8% male) were attending a face-to-face long-term CR program. Of the 87 patients, 78.2% have been on the program for at least 1 year. Every year, PA and ST were objectively assessed by accelerometery. After the CR centre-based program suspension due to COVID-19, efforts were done to create a CR home-based digital model to maintain the continuum of care and avoid losing the previous acquired benefits. After 7 months of suspension, the face-to-face CR centre was reopened and 57.5% (n = 50) patients returned. We completed the assessment of PA and ST of 37 patients (mean age 64.8 ± 8.1, 89.2% male) and compared it as follows: M1) two assessments before COVID-19; M2) last assessment before COVID-19; M3) 7 months after CR program suspension (last trimester of 2020). Patients wore an ActiGraph accelerometer for 7 consecutive days to assess daily and weekly minutes of light PA, moderate-to-vigorous PA and ST. We used repeated-measures ANOVA and Wilcoxon signed rank as a non-parametric alternative. Results Intention-to-treat analysis showed that in M3 patients decreased their average daily time spent in moderate-to-vigorous PA when compared with M2 (M3: 37.90 ± 3.30 min/day vs M2: 45.01 ± 3.14 min/day, p = 0.035), no changes were found between M1 and M2. Average daily time spent in light PA improved significantly from M1 to M2 (M1: 154.81 ± 7.20 min/day vs M2: 169.17 ± 6.44 min/day, p = 0.042) but did not change from M2 to M3. Despite this, in M3, 81.08% of the patients still met the recommendations for moderate-to-vigorous PA (M1: 89.19% and M2: 91.89%). No changes were found in ST. Conclusion Despite a significant decrease on the amount of moderate-to-vigorous PA during the COVID-19 era, most CVD patients, first in the centre-based CR program and after in the home-based CR program, were able to meet PA recommendations throughout the last years. These findings suggest that CVD patients who attend supervised long-term CR programs might be aware of the importance of reaching PA guidelines. Reducing ST by replacing it by PA of any intensity could be an important and reachable target for long-term CR programs.

Funding Acknowledgements Type of funding sources: None. Introduction Cardiac rehabilitation (CR) programs are established interventions to improve cardiovascular health, despite asymmetries in referral. With covid 19 outbreak, cardiac rehabilitation home based (CR-HB) programs emerged as an alternative. However, its adherence and implementation may vary greatly with socio-demographic factors. Purpose To assess adherence to the various components of a CR-HB program.  Methods Prospective cohort study which included patients (pts) who were participating in a centre-based CR program and accepted to participate in a CR-HB after the centre-based CR program closure due to COVID-19. The CR-HB consisted in a multidisciplinary digital CR program, including: 1.patient clinical and exercise risk assessment; 2.psychological tele-appointments; 3. online exercise training sessions; 4.structured online educational program for patients and family members/caregivers;  5. follow-up questionnaires; 6. nutrition tele-appointments; 7. physician tele-appointments Adherence to the program was assessed by drop-out rate; number of exercise sessions in which each patient participated; number of educational sessions attended and a validated questionnaire on therapeutic adherence (composed of 7 questions with minimum punctuation of 7 and maximum of 40 points). Results 116 cardiovascular disease (CVD) pts (62.6 ± 8.9 years, 95 males) who were attending a Centre-based CR program were included in a CR-HB program. Almost 90% (n = 103) of the participants had coronary artery disease; 13.8% pts had heart failure; the mean LVEF was 52 ± 11%. Regarding risk factors, obesity was the most common risk factor (74.7 %) followed by hypertension (59.6%), family history (41.8%), dyslipidaemia (37.9%), diabetes (18.1%), and smoking (12.9%).  Ninety-eight pts (85.5%) successfully completed the program. Almost half (46.9%) of the participants did at least one online exercise training session per week. Among the pts who did online exercise training sessions, 58% did 2-3 times per week, 27% once per week and 15% more than 4 times per week.  The pts participated, on average, in 1.45 ± 2.6 education sessions (rate of participation of 13,2%) and therapeutic adherence was high (39,7 ± 19; min 35-40).  Regarding educational status of the pts, 33 pts (45,2%) had a bachelor degree. These pts tended to participate more in exercise sessions (1,7 ± 1,7 vs 1,2 ± 1,4 sessions per week) and in education sessions (2.13 vs 1.6), although this difference was not statistically significant. The therapeutic adherence did not vary with patients’ level of education.  Conclusion Our results showed that a high percentage of patients completed the program and almost half were weekly physically active. However, in regard to educational sessions, the degree of participation was much lower. Educational status seemed to correlate with a higher degree of participation and, in the future, patient selection might offer better results in these kinds of programs.