Aronov D M, Bubnova M G, Ioseliani D G, Krasnitsky V B, Shovkun T V, Novikova N K, Yarnykh E V
National Research Center for Preventive Medicine.
Moscow City Center of Interventional Cardioangiology, Moscow, Russia.
Kardiologiia. 2017 Mar;57(3):10-19.
to assess clinical efficacy of early post discharge rehabilitation of patients with ischemic heart disease (IHD) after coronary artery bypass grafting (CABG) in conditions of a polyclinical department of cardiological rehabilitation (stage III of cardiorehabilitation).
We included in this study 36 men with IHD in 3-8 weeks (mean 7.8+/-1.6 weeks) after CABG. Patients were randomized in 2groups: patients of the main group attended special "School for patients recovering after CABG" [School] (60-80 min sessions once a week for 5 weeks) and participated in a program of monitored (up to 60 min 3 times a week for 4 months) and unmonitored (home based) exercise training. Patients of the control group attended School and were given advice to do physical exercises at home. Follow up duration was 1 year.
Main group. Compared with baseline values after 4 months exercise duration increased 32.6% (p<0.05), this effect persisted at 12 month; threshold exercise load increased 35.2% (p<0.05) after 4, 53.9% after 6, and 49.5% after 12 month. After 4 and 12 months of training some increases of left ventricular (LV) ejection fraction and stroke volume, and decrease of LV end systolic volume occurred. Physical training in this group was associated with improvement of parameters of quality of life. During 12 months of follow up there were no significant changes of concentrations of total and low density lipoprotein cholesterol (TC, LDLC). In the control group slight increase of exercise duration was observed only at 12 months (9.8%, p<0.05), and it was not accompanied by dynamics of exercise tolerance. Increases of concentrations of TC (10.2%, p<0.05) and LDLC (15.6%, p<0.05) were registered at 12 months. Serious cardiovascular complications in the main group (physical training + educational School) were three times less frequent than in the control group (attendance of School only) (11.1 vs. 39.2%, respectively.
评估在心脏康复多科室（心脏康复III期）条件下，冠状动脉旁路移植术（CABG）后缺血性心脏病（IHD）患者出院后早期康复的临床疗效。
本研究纳入36例CABG术后3 - 8周（平均7.8±1.6周）的IHD男性患者。患者被随机分为两组：主要组患者参加特殊的“CABG术后康复患者学校”[学校]（每周一次，每次60 - 80分钟，共5周），并参与一项有监测的（每周3次，每次最多60分钟，共4个月）和无监测的（居家）运动训练计划。对照组患者参加学校并得到在家进行体育锻炼的建议。随访时间为1年。
主要组。与基线值相比，4个月后运动时长增加32.6%（p<0.05），此效果在12个月时持续；阈运动负荷在4个月后增加35.2%（p<0.05），6个月后增加53.9%，12个月后增加49.5%。训练4个月和12个月后，左心室（LV）射血分数和每搏输出量有所增加，左心室收缩末期容积减小。该组的体育训练与生活质量参数的改善相关。在12个月的随访期间，总胆固醇和低密度脂蛋白胆固醇（TC、LDLC）浓度无显著变化。对照组仅在12个月时观察到运动时长略有增加（9.8%，p<0.05），且未伴有运动耐量的动态变化。12个月时TC浓度增加（10.2%，p<0.05），LDLC浓度增加（15.6%，p<0.05）。主要组（体育训练 + 教育学校）严重心血管并发症的发生率比对照组（仅参加学校）低三倍（分别为11.1%和39.2%）。
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