PHYSICAL INACTIVITY IN PATIENTS WITH ISCHEMIC HEART DISEASE AND PHYSICAL TRAINING IN ITS CORRECTION

Aim – to identify the most affordable way of physical training (PT) in patients with ischemic heart disease (IHD), promoting effective control of the intensity of inactivity and has a high level of adherence in physical training of CHD patients on an outpatient basis – outpatient rehabilitation stage. Materials and methods. The study included 76 male patients with coronary artery disease aged from 49 to 64 years. Results. Among the PE methods used in the study, moderate-intensity treadmill exercises at least thrice weekly are most effective as they promote the most increased exercise tolerance (ET), but in 3 months there is a noticeable reduction in adherence to this PE method. The heavyweight walking method assists in increasing the ET comparable to that of treadmill exercises and in effectively correcting the degree of hypodynamia and preserves high adherence to PE even after 6 months of their regular performance. Conclusion. Hypodynamia as a risk factor for cardiovascular diseases is common and encountered in 86 % of the CHD patients who have undergone percutaneous coronary interventions and myocardial infarction with the baseline exercise capacity being 7 METs or more, as evidenced by treadmill tests. Therefore this category of patients must be actively involved into the programs of cardiac rehabilitation and secondary prevention. On choosing PE methods, preference should be given to the method that aids in increasing ET and adherence to PT and in effectively correcting hypodynamia

CARDIOPROTECTIVE EFFECT OF PHYSICAL REHABILITATION IN PATIENTS WITH ISCHEMIC-ORIGIN DIASTOLIC DYSFUNCTION AFTER PERCUTANEOUS CORONARY INTERVENTION

Aim. To study effect of long-term controlled physical training (CPT) of moderate intensity on diastolic function, depending on the degree of recanalization, in patients with ischemic heart disease (ICD) with left ventricle diastolic dysfunction (DD) who underwent percutaneous coronary intervention (PCI). Material and methods. Patients with ICD (n=60, all males, aged from 49 to 58 years) who had undergone PCI last 3–6 weeks were included into the study. They were randomized into two groups depending on CPT availability in the rehabilitation program. Standard clinical examination, diastolic function assessment, exercise tolerance test were performed at baseline, after 6 and 9 months. Results. The long-term CPT of moderate intensity led to diastolic function improvement in 15.6% of patients after 6 months and 28.1% - in 9 months. Improvement of diastolic function in ICD patients with complete recanalization was observed after 6 months of CPT moderate intensity. Longer period of physical rehabilitation (9 months or more) was required for patients with incomplete recanalization. The improvement of diastolic function without CPT was observed after 6 months in 2 (7.1%) patients with a relaxation type of DD and complete recanalization. Normalization of diastolic function without CPT after 9 months was observed in 10.7% of patients and 3.5% of patients showed DD progression. Conclusion. Inclusion of the long-term CPT of moderate intensity into the rehabilitation program has cardioprotective effect in ICD patients with ischemic DD undergoing PCI.</p