Stress-echocardiography in evaluation of left ventricular inotropic reserve at stages of medical rehabilitation in patients after coronary surgery

Physical rehabilitation of patients after coronary surgery is an important part of comprehensive medical rehabilitation. However, it is challenging to evaluate efficacy of the treatment considering that traditional electrocardiographic methods do not provide detailed information about the status of left ventricular inotropic reserve before and after the treatment. To achieve detailed expert evaluation, we proposed to use cycle ergometer stress-echocardiography with calculation of the degree of maximum increase in left ventricular ejection fraction (ΔEF) at test peak. The study included 35 individuals (mean age of 51.3+7.8 years). Data showed that group of convalescents (n=12) who completed the entire program of physical rehabilitation had the highest maximum EF values (89+2%; ΔEF=48%) in control stress-echocardiography. As a result of comprehensive surgical, pharmacological, and rehabilitational treatment, left ventricular inotropic reserve increased by 70%. Group of patients (n=15) who limited the program of training procedures and cancelled dynamic loads showed significantly lower values of EF and ΔEF: peak EF was 83+5% (ΔEF=37%); the total increase in inotropic reserve was 28%. In group of individuals (n=8) who excluded the regenerative kinetic therapy, control stress-echocardiography showed peak EF of 82+5% (ΔEF=36%) and only 20%-increase in inotropic reserve.