The Features of Post-infarction Period in Patients of Law Tolerance to Physical Activity and Chronic Heart Failure

Abstract

Aim: To determine the features of the early post-infarction period in patients after acute coronary syndrome with concomitant arterial hypertension, depending on the response to dosed physical activity. Materials and Methods: 120 patients with a reduced response to dosed physical activity, with Q, QS MI and concomitant hypertension, who were at the stage of rehabilitation and recovery treatment, were examined. Results: In the course of the study, during the 6-minute walk test, a decrease in oxygen consumption was found in the group of patients of an adequate tolerance to physical activity by 18.42% compared to 15.21% in the group of patients of low tolerance to activity. During the analysis of ABPM (Ambulatory Blood Pressure Monitoring) indicators, it was found that in patients who made up the group of low tolerance to DPA (Dosed Physical Activity), significantly higher average values of systolic blood pressure (SBP) (159.24}3.4) mm Hg and diastolic blood pressure (DBP) (96.26}2 .49) mm Hg, as well as heart rate. During urgent coronary angiography, it was found that in patients of an adequate response to DPA, one vascular lesion was detected in most cases (73.3%), in the group of patients of low tolerance to DPA, one vascular lesion of CA was detected in (14.5%), in (55.5%) recorded two vascular lesions of the CA, and (30%) patients had three or more vascular lesions of the CA. The level of troponin I in blood serum at the time of hospitalization in the group of patients of low tolerance to DPA was 36.38}6.79 ng/ml, the level of NT-proBNP – 726.4}36.32 pg/ml, the level of endothelin-1-9,37}1.34 pmol/L. Conclusions: During the recovery period of treatment of patients after an acute myocardial infarction with concomitant arterial hypertension, a low tolerance to dosed physical activity occurs (in 63.7% of cases), which is accompanied by the appearance of anginal pain, changes in clinical indicators in the early and late post-infarction period and prevents the conducting a full range of rehabilitation measures.