Revista Cubana de Investigaciones Biomédicas (Dec 2012)
Rehabilitación cardiovascular en pacientes con insuficiencia cardíaca crónica de etiología isquémica Cardiovascular rehabilitation in patients with chronic heart failure of ischemic etiology
Abstract
Introducción: a pesar de los avances terapéuticos en nuestro país persisten tasas elevadas de insuficiencia cardíaca, que constituye la vía final de las enfermedades cardiovasculares. Objetivo: evaluar la eficacia de un programa de rehabilitación cardiovascular en pacientes con insuficiencia cardíaca crónica de etiología isquémica. Métodos: se realizó un estudio observacional prospectivo analítico en el Hospital CIMEQ. Se incluyeron 60 pacientes con tratamiento médico convencional. En 30 pacientes se aplicó un programa de rehabilitación que incluyó ejercicios físicos aeróbicos y charlas educativas (grupo activo), los restantes conformaron el grupo control. Resultados: a los 6 meses el grupo activo alcanzó disminución en la frecuencia cardíaca basal de 10 lpm y de 10 mm/hg y 5 mm/hg en cifras de presión arterial sistólica y diastólica, respectivamente. El grupo activo mejoró la capacidad de esfuerzo medida en equivalentes metabólicos (7,6 ± 2 frente a 5,8 ± 2; p Introduction: despite the therapeutic progress achieved in our country, heart failure rates are still high, which is the final pathway toward cardiovascular disease. Objective: evaluate the efficacy of a cardiovascular rehabilitation program in patients with chronic heart failure of ischemic etiology. Methods: an observational analytical prospective study was conducted with 60 patients receiving conventional medical treatment at CIMEQ Hospital. Thirty of the patients underwent a rehabilitation program which included aerobic physical exercise and educational talks (active group). The remaining patients constituted the control group. Results: after six months the active group had achieved a decrease in basal heart rate of 10 lpm and of 10mm/hg and 5mm/hg in systolic and diastolic blood pressure values, respectively. The active group improved their exercise capacity measured as metabolic equivalents (7.6 ± 2 vs. 5.8 ± 2; p < 0.01) and their functional class in 100% versus 33 %; p < 0.05 without any significant differences in exercise time. Rehabilitated patients exhibited a 5 % left ventricular ejection fraction increase. Conclusions: patients with heart failure receiving physical exercise programs improve their cardiac function, their exercise tolerance and their functional class. They also achieve a greater reduction in blood pressure and basal heart rate. It is therefore necessary to strengthen cardiovascular rehabilitation programs and use them with these patients.
