Factors affecting exercise tolerance in cardiac patients at the third phase of rehabilitation

Abstract

Background. Cardiovascular diseases and their complications are the top cause of death and disability; the newly developed rehabilitation methods for these conditions have to be evaluated in terms of tolerability.
 Objective. To examine the factors affecting better exercise tolerance in cardiac patients at the third phase of rehabilitation.
 Methods. The study performed at IvGMA clinic involved 34 patients undergoing the 3rd phase of rehabilitation with a diagnosis of coronary heart disease: 5 (14%) with acute Q myocardial infarction with ST segment elevation, 3 (9%) without ST segment elevation, 3 (9%) non-Q wave myocardial infarction, 23 (68%) unstable angina pectoris. The age of patients was 4976 years (average 59.47 6.08 years), of which 23 were men and 11 women. Each patient underwent a complete clinical and functional examination to assess the anthropometric data, functional indicators of the respiratory and cardiovascular systems, mental functions, and posturography. The rehab course lasted 15 days and included exercise therapy, gym machine training according to an individually designed program, and dosed walking.
 Results. Based on the results of exercise tolerance tests, we formed two case groups: patients of group 1 (n = 14) showed an improvement in the functional class of chronic heart failure according to 6-minute walking test; patients of group 2 (n = 20) showed only insignificant dynamics. Comparison of clinical and functional indicators between the 2 groups revealed that patients of group 1 had more pronounced anxiety and depressive symptoms, and a better preserved function of the respiratory system. A correlation analysis of the total sample of patients detected a correlation relationship between exercise tolerance and functions of the respiratory and cardiovascular systems, anthropometric data, and stabilogram indicators.
 Conclusions. A better exercise tolerance in patients with heart problems was associated with better baseline functions of the respiratory and cardiovascular systems, a lower body mass index, and the optimal dose of statins taken. The exercise tolerance increased in parallel with improvement of stabilogram indicators, which suggests a positive effect of targeted individual training of the equilibrium function to improve the functional result of the cardiac rehabilitation process.