Rehabilitace po infarktu myokardu a revaskularizaci u starších nemocných

Česká verzia

Authors: V. Chaloupka; L. Elbl; S. Nehyba; I. Tomášková
Authors place of work: Oddělení funkčního vyšetřování FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Václav Chaloupka, CSc.
Published in the journal: Vnitř Lék 2005; 51(4): 414-420
Category: Original Contributions

Summary

The goal of the study:
The main goal of our work is to appraise the influence of the physiotherapy to the change of the stress tolerance at older patients, to evaluate their total and cardiovascular mortality and the occurrence of heart complications (reinfarction, revascularization) in the long-term monitoring.

Patients and methods:
There are 582 patients in the sample, 89% men and 11% women, at the average age of 56 ± 11. We divided the sample into the groups of patients >65 years and younger than 65 years. The first group is covered by 145 persons (25%) at the average age of 69 ± 2.7 (65–78). In the group of younger patients there are 437 persons at the average age of 52 ± 7.4 (26–64). The proportional representation of women is the same in both groups, 11%. Into the twomonths ambulatory program were incorporated the patients after the myocardial infarction (IM) or the revascularizational operation because of the angina pectoris (AP). We did the stress echocardiography (ZE) according to the standard proceedings at our place of work at the patients before the categorization into the physiotherapy program. We repeated the examination with the assistance of ZE at the end of two-month program.

Results:
The average values of the stress tolerance of the total sample were 1.5 ± 0.3 W/kg before the physiotherapy and 1.7 ± 0.4 W/kg at the end of the physiotherapy. The values of the stress tolerance before and after the physiotherapy are at older patients lower, but in both groups the improvement of the stress tolerance presents 15%. Cardiovascular mortality in the group of older patients were 7.5% with the 10year probability of survival 70% and in the group of younger patients were 3,5% with the probability of survival 79%. The predictive factors of death were both the parameters of the stress tolerance and some indicators of function and morphology LK, first of all eject fraction.

Conclusion:
The number of older patients at our population,

and by that naturally patients with different forms of ICHS will increase in a progressive way. The intensive physiotherapy shows, and our work confirms it, the same impact to the improvement of stress tolerance both at older patients and younger patients. Just as at younger patients the good function of LK with good stress tolerance will probably be the crucial for their prognosis.

Key words:
physiotherapy – myocardial infarction – older patients

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