Stress-echocardiography in rehabilitation period after by-pass surgery in post-infarct patients with preoperative heart failure
Annotatsiya
The study was performed to estimate effect of exercise training in rehabilitation period after bypass surgery in post-infarction patients with preoperative heart failure. 32 patients after bypass surgery in post-infarction period were investigated with stress echocardiography. All patients before surgery had myocardial infarction and congestive heart failure. Stress tests were performed in post-operative period (after 2–4 months). Dipyridamol-atropine test (DIP) was infused intravenously at a dose of 0,56mg/kg body weigh over 4 min, followed by 4 min of no agent and after that, at the case of the test was still negative, 0,28 mg/kg over 2 min. If test was still negative in 3 minute after DIP infusion 1 mg (in four divided doses of 0,25 mg) atropine was added. Wall-Motion Score Index (WMSI) was calculated with the recommendations of American Society of Echocardiography from 16-segment model of left ventricle. All patients were enrolled in our investigation were examined before and after 3-weeks rehabilitation period was included exercise training and other physical methods of rehabilitation. The DIP test was positive in 29 (90,62%) patients before observation. The resting WMSI was 1,56+/−0,24. Of the positive tests, 18 were positive at low dose (< or = 8 min) and 11 at high dose (>8 min up to 12 min). The WMSI at peak dose increased up to 1,82+/−0,34 (p < 0.05 vs. resting WMSI). After rehabilitation period resting WMSI was non-significant decreased to 1,49+/−0,31, but time to peak was prolonged (p<0.05 vs. baseline). The peak WMSI was significant decreased (1,72+/−0,30, p<0,05). Moreover, resting left ventricular ejection fraction increased from 50,67+/−3,98% to 54,45+/−3,75% (p<0,05). Exercise training may be recommended in rehabilitation period after bypass surgery in post-infarct patients with preoperative heart failure.