Efficiency of physical rehabilitation of patients with heart failure after myocardial infarction

Aim. To study the effectiveness of a 6-month training program in patients with New York Heart Association (NYHA) class II-III heart failure (HF) after myocardial infarction (MI).

Material and methods. Patients (n=40) with left ventricular (LV) ejection fraction (EF) <45% after MI were included. Patients were randomized into the main group (n=20) with training and drug therapy and the control group (n=20) with therapy only. Training program and follow-up lasted 6 months.

Results. According to the bicycle ergometry after 6 months, the main group patients demonstrated a significant increase in the intensity (by 16,4%, p<0,01) and duration (by 21,3%, p<0,01) of physical activity (PA) against a decrease in these parameters in patients of control group (by 13,9%, p<0,01 and 20,4%, p<0,01, respectively). Only in the trained patients, LVEF increased after 6 months (by 6,5%, p=0,03) versus decrease (by 8,6%, p=0,024) in the control group. Systemic vascular resistance (SVR) against the background of physical training after 6 months decreased by 180±64 dyn·s·cm⁻⁵ (p=0,001) and did not change in the control group. Minnesota Living with Heart Failure Questionnaire parameters improved after 6 months with PA (by 28,4±3,8%, p=0,001) and worsened without it (by 26,9±3,6%, p=0,001). With the training program, there was a decrease in the number of angina attacks (by 31,1%, p=0,022), complaints of dyspnea (by 15%, p=0,044) and muscle fatigue (by 21,6%, p=0,039). In the control group, these indicators did not change.

Conclusion. The 6-month training program for patients with NYHA class II-III HF contributed to a decrease in the severity of clinical symptoms, improved tolerance to PT, echocardiography parameters and quality of life. It is advisable to involve patients with HF and reduced LVEF in cardiac rehabilitation programs based on physical training.

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