The influence of physical rehabilitation of patients on the course of chronic heart failure

Abstract

IIntriduction. Complex rehabilitation programs makes an important role in improving exercise tolerance and patients functional status with cardiovascular pathology.Aim. To study the physical rehabilitation effect on the functional status, pro-inflammatory cytokines levels and cardiovascular inflammation biomarker (high-sensitivity C-reactive protein) in heart failure patients with different ejection fractions.Materials and methods. The study included 160 patients with chronic heart failure (84 men and 76 women, mean age 69.4 ± 8.8 years). Two groups of patients with preserved and reduced left ventricular ejection fraction were identified. The groups were divided into two subgroups: the first – those who underwent physical rehabilitation for a year and received standard drug therapy; the second one received exclusively standard drug therapy. At inclusion and after a year of observation, patients were examined: determination of functional status, levels of pro-inflammatory cytokines, serum hs-C-reactive protein, NT-proBNP.Results. Regardless of left ventricular ejection fraction, in the studied patients subgroups undergone physical rehabilitation, a statistically significant decrease in the proinflammatory cytokines levels, NT-proBNP and hs-C-reactive protein was noted. The study also demonstrated the physical rehabilitation beneficial effects on the patients with HF functional status. Thus, the distance walked within 6 minutes and its relation to the proper indicator in patients who underwent physical rehabilitation increased in comparison with the initial indicators during the initial examination of patients and in comparison with control subgroups. This may indicate the positive properly selected physical activity impact on circulatory compensation and the HF course.Conclusion. Carrying out physical rehabilitation for chronic heart failure leads to an improvement in functional status, a decrease in the NT-proBNP, pro-inflammatory cytokines and high-sensitivity C-reactive protein level in comparison with the results of managing patients on drug therapy (without rehabilitation).