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Physical rehabilitation based on the phenomenon of ischemic preconditioning in patients with ischemic heart disease
Author(s) -
Lyamidezhda P,
Kotelnikova Elena V,
Karpova Ella S,
Senchikhin Valery N,
Lyamina Svetlana V,
Downey H Fred,
Manukhina Eugenia B
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.1085.17
Subject(s) - medicine , ejection fraction , cardiology , treadmill , ischemia , st depression , revascularization , heart rate , rehabilitation , disease , ischemic preconditioning , st segment , physical therapy , myocardial infarction , heart failure , blood pressure
Ischemic preconditioning (IP) triggers mechanisms that are cardioprotective during non‐fatal ischemia. Exercise programs are frequently prescribed for patients with ischemic heart disease (IHD). Here we report a strategy for physical rehabilitation of IHD patients based on presumed IP. Patients with stable IHD (age 38–65 y; ejection fraction >;40%), incomplete revascularization after transcutaneous coronary angioplasty, and positive results of a diagnostic exercise stress test were studied. The IP group (53.9±6.2 y; n=11) performed treadmill exercise for 10 days at 70–80% of diagnostic intensity, with duration determined by the time to ST depression and/or appearance of anginal symptoms. The control (C) group (56.1±4.8 y, n=10) performed standard exercise training for 10 days at 50–60% of diagnostic intensity for 30 min. Monitored safety indices: ECG, BP, heart rate, and myocardial injury markers. Post‐training, for the IP group compared to the C group, diagnostic exercise duration increased by 17.5±3.6% vs 4.1±1.2% (p <0.05); MET by 9.3±2.6% vs 2.4±1.1% (p <0.05); double product by 6.5±2.9% vs 2.1±1.0% (p=0.021); maximum ST depression decreased by 46.3±6.8% in the IP group vs 9.8±1.6% in the C group (p <0.001). Safety indices were within reference ranges in both groups. Thus, exercise‐induced IP effectively improves exercise tolerance in IHD patients.