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Pol. Merkur. Lek (Pol. Med. J.), 2014, XXXVII/218: 077-081 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2014, XXXVII/218: 077-081

Title: Role of controlled physical activity as a method of therapy in patients with heart failure after invasive treatment of angina pectoris

/ Authors: Irzmański R., Kapusta J., Kowalski J.

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Role of controlled physical activity as a method of therapy in patients with heart failure after invasive treatment of angina pectoris


Irzmański R., Kapusta J., Kowalski J.

Subward of Cardiologic Rehabilitation of Department of Internal Diseases and Cardiologic Rehabilitation of Medical University in Lodz, Poland

Due to the aging of the population is an increase in the incidence of heart failure. According to the current guidelines for conduct in the treatment of cardiovascular diseases, rehabilitation is introduced in the first treatment period. Individually matched to the severity of illness of each patient, increases the quality of life of patients and reduces mortality in this group of patients.
The aim of the study
was to evaluate the effect of controlled exercise on left ventricular systolic function of heart and change the level of concentration of natriuretic peptide NT-pro-BNP in patients with heart failure after invasive treatment of angina pectoris.
Material and methods
. The study group consisted of 87 patients, men and women aged 35 to 85 years (mean age 65.6±10.4) with a diagnosis of heart failure. Patients were divided into 3 groups. I group numbering 19 patients (67.3±7.8) were subjected to two-week cardiac rehabilitation program, representing 46. Group II patients (59.4 ± 10.9) was qualified for the 4-week program. The basis for rehabilitation of patients accounted for interval training was performed using a bicycle ergometer. Group III – control, representing 22 patients (68.1 ± 9.2) were excluded from the training groups because of the high risk. Used with them individually tailored program of cardiac rehabilitation. All patients were performed : submaximal exercise test, echocardiography and examined the concentration of NT-pro-BNP (N-terminal pro-B-type natriuretic peptide). After a period of 6 months from the end of the second phase of cardiac rehabilitation in 32 patients who agreed repeated the scope of clinical trials.
Results
. In groups where physical training was conducted controlled noticed an improvement in EF and reduction of NT pro-BNP. It was also a significant, negative correlation between the degree of damage to the left ventricle (EF) , and the level of NT pro-BNP. After a period of 6 months from the end of the second stage of rehabilitation, the analysis showed a statistically significant further and improve. It was observed that the best results were obtained in the group with the longest period of rehabilitation.
Conclusion
. Rehabilitation, part of cardiac rehabilitation is an important component of therapy in patients with heart failure. By influencing the improvement actions cardiovascular favorable effect on the clinical course of the disease.

Key words: cardiac rehabilitation, exercise capacity, heart failure, ejection fraction, natriuretic peptides

Pol. Merk. Lek., 2014, XXXVII, 218, 77