PERSONALIZED ASSESSMENT OF EXERCISE TOLERANCE IN PATIENTS WITH ACUTE CORONARY SYNDROME AFTER ENDOVASCULAR REVASCULARIZATION AT THE INPATIENT STAGE OF CARDIAC REHABILITATION

Rybin Evgeny Vladimirovich, Obrezan Andrey Grigor'evich

Coronary heart disease remains one of the most significant diseases in the Russian Federation, and methods of endovascular myocardial revascularization are currently the main ones in the treatment of acute coronary syndrome. The effectiveness of revascularization largely depends on the quality and completeness of subsequent rehabilitation measures, which should be applied to each patient if there is a rehabilitation potential. Patients with acute coronary syndrome admitted to the hospital are extremely heterogeneous in terms of clinical and anamnestic data, laboratory and instrumental indicators of impaired functioning of the cardiovascular system, and the amount of myocardial revascularization performed, which requires a personalized approach and assessment of functional parameters in the process of planning effective and safe rehabilitation methods. The aim of the study was to evaluate exercise tolerance in patients with acute coronary syndrome after endovascular revascularization with different contractile function of the left ventricle during exercise tests. Before the end of the inpatient stage of cardiorehabilitation, patients were selected for exercise tests (a symptom of limited cycling ergometry and a six-minute walking test with an assessment of the subjective intensity of physical activity and severity of shortness of breath according to Borg). According to the results of stress tests in groups with different left ventricular ejection fraction, the exercise tolerance level was stratified. Differences in the tolerance of physical activity by patients of different groups were revealed, which led to significant differences in the distribution of exercise tolerance levels. Personalized assessment of exercise tolerance in the process of cardiorehabilitation of patients with acute coronary syndrome after endovascular revascularization is the basis for the formation of individual intensity and duration of physical training at all stages, which contributes to improving the effectiveness of rehabilitation of patients with coronary heart disease. The results of the work are aimed at improving the system of physical rehabilitation of patients after revascularizing surgical interventions and can be applied to solve the important socio-economic task of restoring patients' ability to work.

Keywords:acute coronary syndrome; exercise tolerance; endovascular myocardial revascularization; six-minute walking test, bicycle ergometry, personalized cardiac rehabilitation.