EXTERNAL RESPIRATION FUNCTION EVALUATION AND ITS SIGNIFICANCE IN THE DETERMINATION OF CARDIOREHABILITATIVE AMBULATORY STAGE EFFECTIVENESS
Objective - to study the dynamics of external respiration function (ERF) parameters in the process of rehabilitation of patients after acute coronary syndrome (ACS). Material and methods. 30 patients were enrolled in the study; after acute coronary syndrome with the outcome into myocardial infarction or unstable angina they were administered ambulatory stage of cardiorehabilitation in the teaching hospital of the Ivanovo State Medical Academy. Spirometry parameters were analyzed at the beginning and at the end of rehabilitation course. Physical load tolerance was estimated by 6 minute walk test (SMW) and veloergometry (VEM); individual subjective physical load tolerance was evaluated by Borg scale. Results. Initially ERF parameters were decreased in each second patient. At the end of cardiorehabilitation course more high (in comparison with initial indices) functional class (FC) of chronic cardiac insufficiency (CCI) was registered in 10 patients (33%); average distance in SMW test increased from 410,5 (355; 455) to 450 (400; 500) m, p = 0,001), parameters of Borg scale were diminished (from 12 (11; 13) to 10 (8; 12) points, p < 0,05), performed load power was heightened with VEM (from 75 (50; 100) to 100 (75; 125) w, p = 0,003). At the discharge from the hospital in 24 (80%) patients motion activity corresponded to V stage, in 4 (13%) ones - to VI stage. At the end of cardiorehabilitation course significant positive dynamics of spirometry parameters was demonstrated: vital capacity of the lungs function - from 2,76 (2,17; 3,34) to 2,88 (2,3; 3,46) l (p = 0,047); forced expiration volume per1 sec (FEV1) - from 2,29 (1,64; 2,94) to 2,4 (2,18; 3,14) l (p = 0,009), maximal ventilation of the lungs test (MVL) - from 55 (40,1; 79) to 71,3 (41,3; 85) l (p = 0,0001). Conclusions. The conjugation of the parameters of physical load tolerance and ERF was revealed; it testified to the fact that in more high initial parameters of EEF the better tolerance to physical load took place both before and after ambulatory cardiorehabilitation course.