Author + information
- Raisa Khusainovna Trigulova1,
- Alexander Borisovich Shek1,
- Nadira Akhmatovna Azimova1 and
- Nargiza Farkhadovna Tashkenbaeva1
The work was initiated to assess results of loading test in patients with acute myocardial infarction (AMI) hospitalized at the rehabilitation department.
79 male patients aged from 49.6±0.8 years recruited to be included into this 3-5-day study were hospitalized at the emergency department, Tertiary Medical Center of Cardiology undergoing therapy for AMI and transferred to the department of rehabilitation of cardiac arrhythmias to receive basic medications. In compliance with the protocol of the study medical history data, clinical and hemodynamic parameters, 12-lead rest ECG findings, results of clinical and biochemical analyses were examined; echocardiographic study and daily ECG monitoring being performed. The test with physical load was performed before the patients’ discharge form the hospital on 12.2 ± 0.3 day after AMI in the average.
Early cycle ergometry (CE) demonstrated low physical potential (≤50 W) in 51 patients (67.1%) in the whole. Further analysis of CE results was performed in subgroups by size of IM, that is, with AMI with elevation of ST segment (1st group, n=45) and without stable ST segment elevation (2nd group, n=31). There were no significant intergroup differences in parameters of loading test and integral dynamics by the size of IM. ΔDouble product% increment in patients of the 1st group (105.8±5.6%) was 1.05 times lower than the one in the 2nd group patients (111.1±5.4%). Incidence of ventricular premature beats (VPB) and its appearance during the loading test in the 1st group patients was more frequent (n=23, 51.1%; 1.74 ± 0.2) than in the 2nd group patients (n=12, 38.7%; 1.3 ± 0.17) (P>0.05). VPB of high grades (4A and 4B) were registered in 5 (11.1%) and 2 (6.5%) patients of the 1st and 2nd groups, respectively (P>0.05). Submaximal heart rate (HR) was reached in 14 (31.1%) of the 1st group patients, in 2 (11%) patients being accompanied by depression of ST segment and in one case with ST segment elevation. The target HR in the 2nd group patients was reached in the 2nd group patients less frequently (n=7, 22.6%) being accompanied neither by decline nor elevation of ST segment. Predictively unfavorable types of VPB during the loading test were registered in 2 patients (4,4%) of the 1st group, paired VPB being observed on 1-2 minutes of restitution and in none of the 2nd group patients.
Our findings serve as one more proof of safety of loading test in patients with AMI with Q wave and without that.