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Physical exercises at an early stage of cardiac rehabilitation in coronary artery disease patients with incomplete myocardial revascularization

Session Poster session 3 Monday 08:30 - 18:00

Speaker Nadezda Lyamina

Event : Heart Failure 2015

  • Topic : preventive cardiology
  • Sub-topic : Exercise Testing
  • Session type : Poster Session

Authors : N Lyamina (Saratov,RU), EA Kotelnikova (Saratov,RU), E Bizyaeva (Saratov,RU), V Senchikhin (Saratov,RU), T Lipchanskaya (Saratov,RU)

Authors:
N Lyamina1 , EA Kotelnikova1 , E Bizyaeva1 , V Senchikhin1 , T Lipchanskaya1 , 1Saratov Scientific Research Institute of Cardiology - Saratov - Russian Federation ,

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2015 ) 17 ( Supplement 1 ), 356

Objective: To compare cardioprotective effect of controlled physical exercises (CPE) of high (based on the phenomenon of ischemic preconditioning (IP)) and moderate intensity in early rehabilitation in coronary artery disease (CAD) patients with incomplete myocardial revascularization (IMR) after percutaneous coronary intervention (PCI). Material and Methods: We examined 65 CAD patients (men and women) aged 39-65 (median 54.6 ± 9.2 y.o.) with IMR after PCI. Verification was performed in the first 10 days after PCI. Paired diagnostic stress-test showed the phenomenon of ischemic preconditioning (IP) in 23 patients. These patients were randomized in 2 groups and performed 10-days course of daily CPE of different intensity. I group patients (n=11) participated in high intensive CPE (80% of supreme threshold exercise intensity) with the aim of IP phenomenon preservation. Duration of basic period in daily CPE was determined by time to ST depression and/or angina pectoris development (19-43 min, median 29.8 min). II group patients (n=12) performed daily CPE of moderate intensity (60% of supreme threshold exercise intensity) with duration of 30 minutes. CPE were carried out under the results of ECG, blood pressure and heart rate monitoring, markers of myocardial necrosis (myoglobin, troponin, MB-CK, BNP). This confirmed the safety of CPE and formation of IP. The results of coronary angiography were comparable in patients of both groups. Results. Compare of effectiveness of 10-days CPE courses with high and moderate intensity in parallel groups showed that exercise duration in the I group increased by 16.1 ± 3.6%, and in the II group - by 4.1 ± 1.2% (p < 0.05), metabolic equivalent increased by 9.3 ± 2.6% and 2.4 ± 1.1% (p < 0.05), respectively, maximum ST depression in I group was decreased by 46.3 ± 6.8% and in II group - by 9.8 ± 1.6% (p < 0.001). Results of Holter ECG monitoring in I group patients showed decreasing of ectopic activity by 23.6%, in II group patients - by 10.3%. Overall duration of ST depression per calendar day significantly decreased in I group - by 31.8%, in II group - by 9.9%. Values of myocardial necrosis stayed within reference ranges. Conclusion. 10-days courses of 80% intensity CPE in CAD patients with IMR were more effective in adaptation to ischemia and cardioprotective effect formation as compared to 60% intensity CPE. Short courses of daily PE of high intensity form cardioprotective effect in CAD patients with IMR and reduce the time for rehabilitation.

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