Comprehensive rehabilitation in chronic heart failure.

Chronic heart failure (CHF) is a complex disease process connected with cardiovascular system as well as other organs and skeletal muscles. In connection with the above, cardiac rehabilitation, consisting of exercise training and diet supplementation, aims at recovery of physical, social and psychic function and removing risk factors influencing the occurrence of circulatory system diseases. Evidence has shown that exercise training in CHF patients, both aerobic and resistance, can increase peak oxygen consumption and exercise capacity, improve NYHA (New York Heart Association) functional class, reduce mortality and improve the quality of life. Evidence suggests that most improvement is due to the effects of training on the peripheral circulation and skeletal muscle, rather than on the heart itself. Exercise training can improve skeletal muscle metabolism, increase blood flow within the active skeletal muscles, increase capillary density, promote the synthesis and release of nitric oxide, improve angiogenesis, and decrease oxidative stress. Physical effort reduces sympathetic arousal and increases parasympathetic arousal, thus reducing cardiac dysrythmia and ischemia. Mitochondria start working harder, as the demand for energy is higher and electron flow provides energy in the form of ATP. Studies have consistently demonstrated that exercise training is safe and has no deleterious effect on central haemodynamics, left ventricular remodeling, systolic or diastolic function, or myocardial metabolism. Taking several supplements that have documented roles in medical therapy, including vitamins B, C and E, coenzyme Q10, alpha-lipoic acid, chromium, omega-3 polyunsaturated fatty acids, L-carnitine, and quercetin, has beneficiary effect on many diseases, including CHF. In our experience, 19 patients with CHF who undertook resistance (weight) training and food supplementation, returned to their normal activities after 4 months, without any complaints.

Weight training and appropriate nutrient supplementation as an alternative method to pharmacological treatment in rehabilitation of post-myocardial infarction patients.

The article describes the impact of weight training, micro-elements and vitamins on rehabilitation in post-myocardial infarction patients. Cardiac rehabilitation is a multi-disciplinary and multi-faceted intervention aimed at restoring well-being and retarding disease progression in patients with heart disease. It has been shown that exercise-based cardiac rehabilitation is effective in reducing total and cardiovascular mortality. Intake of vitamins and other diet supplements was reported to exert beneficial effects. Pharmacological medication is associated with an increased risk of severe arrhythmia, and many adverse outcomes. Therefore, since conventional medicine only relieves the symptoms, cellular nutrition should be used in order to improve the quality of life in post-myocardial infarction patients. These elements prevent another infarction. The following nutrients are reported to have beneficial effects on general and cardiovascular health: amino acids, vitamins, coenzyme Q10, pycnogenol, inositol, omega-3 fatty acids, macromineral elements, and trace mineral elements. In conclusion, the review indicates that appropriate weight training and diet supplementation ensure full recovery and elimination of risk factors for cardiovascular diseases.