Abstract
Introduction. In a number of studies, a reduction in the risk of repeated hospitalizations was revealed against the background of ongoing cardiac rehabilitation after coronary artery bypass grafting (CABG). Physical cardioresity can be an effective means of restoring the adaptive capacity of the body and optimizing endothelial dysfunction after heart surgery. Objective: to study the effectiveness of the optimal cardiorehabilitation training program on vasomotor function of the endothelium in cardiosurgical patients.
Materials and methods. In our study, 56 patients undergoing aortocoronary bypass surgery under conditions of artificial circulation (AC), with an AC duration of 56.0±20.5 min, were examined. Patients were divided into two groups: the control group (n=28) who did not undergo the cardio rehabilitation course on bikes at the age of 55.2±1.5 years, and the main group (n=28) – with the implementation of a course of cardiorehabilitation on exercise bikes, at the age of 56.9±1.4 years (p>0.05). Of these, 30 (53.5%) men, 26 (46.5%) women. Gender was not considered. Aerobic training was conducted on Schiller stationary bikes from 10–12 days after CABG. The load power was from 25 to 70–90 W. Before and after the course of cardiac rehabilitation, the linear blood flow velocity, the diameter of the brachial artery with ultrasound dopplerography by the Celermajer method were measured, the level of lactate, glucose, pH, pCO2, pO2, BE in the blood, external respiration, heart rate and blood pressure was assessed.
Results. When assessing the indices in the basis of the group at the end of the course of cardiac rehabilitation, a significant increase in the diameter of the brachial artery after the occlusion test to 0.52±0.025 cm, an increase in the linear velocity to 0.15±0.035 m/s, a decrease in systolic blood pressure after exercise 155.0±5.7 mm Hg (p<0.05), an increase in the value of VO2peak to 19.0±0.9 ml/kg/min (p<0.05), lactate in the blood decreased to 1.7±0.2 mmol/l (p<0.05).
Conclusion. A competently chosen protocol of the training program can optimize endothelial dysfunction, as well as with further regular classes, it can become a secondary prevention of repeated cardiovascular diseases.
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About the authors
- Leo A. Bockeria, Academician of the Russian Academy of Sciences and Russian Academy of Medical Sciences, President, ORCID
- Tea T. Kakuchaya, Dr. Med. Sc., Head of Department, ORCID
- Tamara G. Dzhitava, Cand. Med. Sc., Deputy Head of Department, ORCID
- Arzhana M. Kuular, Cand. Med. Sc., Junior Researcher, ORCID
- Zarina K. Tokaeva, Cardiologist,ORCID
- Nona V. Pachuashvili, Cand. Med. Sc., Cardiologist, ORCID
- Irina I. Domracheva, Cardiologist, ORCID
- Nino E. Zakaraya, Cardiologist, ORCID
- Angelina G. Filatova, Cardiologist, ORCID
