Issue №3-91, 2019

Improving the efficiency of cardiorehabilitation the inclusion of methods of metabolic adaptation of ischemic myocardium

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1 Knyazeva T. A., 1 Nikiforova T. I., 1 Erеmushkin M. A., 1 Styazhkina, E. M., 1 Chukina I.M.

1 National Medical Research Center of Rehabilitation and Balneology of the Ministry of Healthcare of the Russian Federation, Moscow, Russia


ABSTRACT

Despite the achievements in recent years in the treatment, prevention and rehabilitation of patients with coronary heartdisease (CHD), including after acute coronary syndrome and cardiac surgery, the search for new, more advanced methodsof cardio-rehabilitation remains an urgent task in connection with the need and need for it in most patients with CHD afterpercutaneous coronary interventions (PCI), surgical myocardial vascularization. Despite the cardio-surgical interventions,the signs of deeply ischemic myocardium remain in patients with ischemic heart disease, which significantly reduces theeffectiveness of the methods of cardiorehabilitation. The aim of this study was to develop with scientific justification improvedprograms of cardio-rehabilitation of patients after acute coronary syndrome and cardiac surgery. The study included70 patients who were randomized into two groups: 1-St, main (40 people), 2-nd, control (30 people), comparable in the mainclinical manifestations. Patients of the control group received improved methods of physical training, with the inclusion oftherapeutic gymnastics in the hall, not previously used in cardiology interval cyclic training on the treadmill and sensorytrack, horizontal exercise bike daily № 10. Patients of the main group received in addition to these physical exercises, proceduresthat improve metabolic processes in ischemic myocardium: enhanced external counterpulsation, low-intensity lasertherapy by cardiac technique, dry-air carbon dioxide baths daily № 10. As a result of the complex rehabilitation in patientsof the main group compared with the control achieved more pronounced anti-ischemic, antianginal, antiarrhythmic, antihypoxiceffects, by eliminating metabolic disorders in the ischemic myocardium and the development of cardioprotectionof ischemic myocardium, the so-called effect of “preconditioning”. The specified result is achieved by the integration ofimproved methods of cardio training with interval cyclic inclusion of classes simultaneously with treatment of metabolicprotection of the myocardium.


KEYWORDS: metabolic adaptation, ischemia, “preconditioning”, cardioprotection, interval cyclic training, enhanced external counterpulsation, infrared laser therapy, gas-air carbon dioxide baths.



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