cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-2082Research ArticleИНФАРКТ МИОКАРДАMYOCARDIAL INFARCTIONПАссивные ТРенировки при Инфаркте миокАРда у пожилыХ (исследование ПАТРИАРХ): влияние на внутрисердечную гемодинамику и аритмогенный статусPAssive TRaining In elderly patients with Acute myocaRdial infarCtion (PATRIARCH Study): effects on intracardiac hemodynamics and arrhythmiasСуминА. Н.SuminA. N.

заведующий кардиологическим отделением

sumian@cardio.kem.ruБезденежныхА. В.BezdenezhnykhA. V.

врач отделения кардиологии № 2

БайдинаО. М.BaydinaO. M.

врач отделения функциональной диагностики

ПоповаТ. А.PopovaT. A.

врач отделения кардиологии № 2

ХайрединоваО. П.KhayredinovaO. P.

заведующая отделением кардиологии № 2

НИИ комплексных проблем сердечно-сосудистых заболеваний СО РАМН. КемеровоResearch Institute of Complex Cardiovascular Disease Problems, Siberian Branch, Russian Academy of Medical Sciences. KemerovoФГЛПУ “Научно-клинический центр охраны здоровья шахтеров”. Ленинск-КузнецкийResearch and Clinical Centre of Miners’ Health. Leninsk-Kuznetsky201020062010932937Copyright © Сумин А.Н., Безденежных А.В., Байдина О.М., Попова Т.А., Хайрединова О.П., 20102010Сумин А.Н., Безденежных А.В., Байдина О.М., Попова Т.А., Хайрединова О.П.Sumin A.N., Bezdenezhnykh A.V., Baydina O.M., Popova T.A., Khayredinova O.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2082Цель

Цель. Изучить влияние электростимуляции скелетных мышц (ЭМС) на показатели внутрисердечной гемодинамики и аритмогенный статус у больных инфарктом миокарда (ИМ) старших возрастных групп. Материал и методы. Обследованы 92 больных ИМ > 60 лет (средний возраст 71,4±0,6 лет), разделенных на 4 группы (гр.): 2 гр. ЭМС в возрасте 60—69 лет (n=18) и > 70 лет (n=30) и 2 контрольные гр. (ГК) — в возрасте 60-69 лет (n=19) и > 70 лет (n=25). В основных группах (ОГ) с 4-5 дня лечения проводили ЭМС 2 ч в сут. в течение 10 дней с помощью аппарата “Миоритм-040”. Перед выпиской из стационара оценивали силу и выносливость скелетных мышц нижних конечностей, толерантность к физической нагрузке (ТФН), проводили суточное мониторирование (СМ) электрокардиограммы (ЭКГ) и эхокардиографию (ЭхоКГ). Результаты. У больных ИМ > 70 лет курс ЭМС повысил силу и выносливость мышц нижних конечностей и ТФН. В возрасте 60-69 лет такого эффекта не наблюдалось. После ЭМС в ОГ уменьшилась средняя частота сердечных сокращений (ЧСС) в течение сут., отсутствовали неблагоприятные реакции внутрисердечной гемодинамики по сравнению с ГК. ТФН на ВЭМ у больных старших возрастных гр. имела сильную прямую корреляционную связь с силой и выносливостью мышц нижних конечностей, обратную средней силы — с возрастом и максимальной ЧСС в ночное время. Заключение. ЭМС является безопасным методом повышения ТФН у больных ИМ > 70 лет, заслуживает дальнейшего изучения и практического применения.

 

 

Aim. To study the effects of skeletal electromyostimulation (SEMS) on intracardiac hemodynamics and arrhythmia risk in elderly patients with myocardial infarction (MI). Material and methods. The study included 92 MI patients aged >60 years (mean age 71,4±0,6 years), divided into 4 groups: two SEMS groups of patients aged 60-69 years (n=18) and over 70 years (n=30), plus two control groups, aged 60-69 years (n=19) and over 70 years (n=25). In the main groups (MG), SEMS course was started from treatment day 4-5 (2 hours per day, 10 days; “Myorithm-040” device). Before hospital discharge, strength and endurance of leg skeletal muscles, general physical stress tolerability (PST), 24-hour electrocardiography (ECG) monitoring, and echocardiography (EchoCG) parameters were assessed. Results. In MI patients aged over 70 years, SEMS course increased power and endurance of leg muscles and PST, while these effects were absent among patients aged 60-69 years. In the MG, SEMS was associated with reduced mean circadian heart rate (HR), and no adverse changes in intracardiac hemodynamics, comparing to the CG. During veloergometry stress test, PST in elderly patients significantly and directly correlated with leg muscle strength and endurance, and moderately and inversely correlated with age and maximal HR at night. Conclusion. SEMS is a safe method of PST increase in MI patients aged over 70 years. This method should be studied further and implemented into clinical practice.

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The authors declare that there are no conflicts of interest present.