Chatian Monika, Tarchalski Janusz Lech, Lisowski Jacek, Poziomska-Piatkowska Elzbieta
Pol Merkur Lekarski. 2014 Feb;36(212):88-91.
Myocardial infraction, sudden cardiac death next is one of the most serious clinical demonstrations of ischaemic heart diseases. It is characterized by an irreversible destruction (necrosis) of a part of cardiac muscle, caused by severe narrowing or blood clot (thrombosis) in the lumen of coronary arteries. The long-term, systematic and individually selected program of the physical rehabilitation has a beneficial effect to the improvement in the physical fitness at patients, after an myocardial infarction. The aim of this work was to examine the influence of the outpatient, cardiological rehabilitation on the physical fitness and the normalization of the arterial pressure at patients after STEMI, treated with methods of invasive cardiology, and determining effects of the rehabilitation.
The study included 108 patients (93 men and 15 women). An average age of patients was 53. Examined patients were divided into 2 groups: rehabilitated (55 people) and control (53 people). The program of the cardiologic rehabilitation included 24 forty-minute training sessions, for 2-3 times during the week. Every training session spread through 10 minutes of the general keep-fit exercise (warm-up), 24 minutes of the ride on cycloergometer (intervallic training) with submaximal load adjusted individually for every patient, under the constant electrocardiographic scrutiny of the action of the heart, and 6 minutes of respiratory exercises. The criterion of intensity of a physical effort was determined on the basis of a Bruce test according to on the level of the 70% of the maximum limit of the heart rate. The rehabilitation lasted about 3 months.
Obtained findings show that the outpatient, cardiologic rehabilitation has a beneficial effect for the improvement in the physical fitness and the decrease in value of the rest arterial pressure at patients after STEMI. Examinations show the increase of the maximum load (max MET'S) and longer duration of the exercise test.
Above findings confirm the effectiveness of the cardiological rehabilitation, although they are not spectacular. Perhaps if they increase the frequency and intensity and number of training sessions, the results would be more significant.
心肌梗死，其次是心源性猝死，是缺血性心脏病最严重的临床症状之一。其特征是部分心肌发生不可逆性破坏（坏死），这是由冠状动脉管腔严重狭窄或血栓形成所致。长期、系统且个性化的体能康复计划对心肌梗死后患者的体能改善具有有益作用。本研究的目的是探讨门诊心脏康复对接受侵入性心脏病学治疗的ST段抬高型心肌梗死（STEMI）患者体能及动脉血压正常化的影响，并确定康复效果。
该研究纳入了108例患者（93例男性和15例女性）。患者的平均年龄为53岁。被检查的患者分为两组：康复组（55人）和对照组（53人）。心脏康复计划包括每周2 - 3次、每次24节时长40分钟的训练课程。每次训练课程包括10分钟的一般性健身锻炼（热身）、24分钟在功率自行车上的骑行（间歇训练），根据每位患者的情况单独调整次最大负荷，并在持续心电图监测心脏活动的情况下进行，以及6分钟的呼吸练习。体力活动强度标准根据布鲁斯试验，依据心率最大限值的70%水平来确定。康复持续约3个月。
所得结果表明，门诊心脏康复对STEMI后患者的体能改善及静息动脉血压值降低具有有益作用。检查显示最大负荷（最大代谢当量）增加，运动试验持续时间延长。
上述结果证实了心脏康复的有效性，尽管效果并不显著。或许增加训练课程的频率、强度和次数，结果会更显著。
