Evaluation of the impact of complex rehabilitation in patients with chronic heart failure

Abstract

Aim: To evaluate the effect of 3 months of complex rehabilitation of left ventricular (LV) systolic function, geometry and function capacity in patient with chronic heart failure (CHF). Methods: 43 stable patients with CHF II–IV NYHA (aged mean 49.8±1.8) participated in complex home-based exercise rehabilitation programs for 3 month, 3 times/week. All participated performed 6 minute walk test (6 MWT) with Borg’s scale before and after. Heart rate, blood pressure and 2D Doppler echocardiography was assessed before and after 3 months rehabilitation. Descriptive analysis, paired-samples T test and Wilcoxon signed rank test were calculated with SPSS16 package. Results: At beginning of this study patients with NYHA II/III/IV were 16%/52%/32% respectively. Mean LV ejection fraction (EF) was 20.7±7.8%. After 3 months of complex rehabilitation the LVEFhad increased by a mean value (Δm) of 6.5% (p<0.01), systolic volume Δm=11.2 ml (p<0.05), distance of 6 MWT Δm=23.7 m (p<0.05) and LV end-diastolic diameterhad decreased by Δm=2.5 mm (p<0.05), LV end-diastolic diameter index Δm=1.3 (p<0.05), LV end-diastolic and sistolic volume (respectively Δm=19.9 ml, p<0.05; Δm=29.36 ml, p<0.001), right ventricular and atrium diameters (respectively Δm=3.0 mm, p<0.01; Δm=3.4 mm, p<0.05), heart rate Δm=7.5, p<0.05. After 3 months of complex rehabilitation HYHA class and dyspnea by Borg’s scale were reduced statistically significantly. Conclusion: Complex rehabilitation is effective and results in improved LV systolic function. Abnormal remodeling is attenuated.