[Cardiac rehabilitation: investigation of efficacy, results, perspectives]. / Kardioreabilitatsiya: issledovaniya effektivnosti, rezul'taty, perspektivy.

Previous research experience on cardiac rehabilitation programs as a part of general health care system has shown that they are an important part of the management of cardiovascular patients. Improving quality of life, reducing the severity of risk factors, increasing physical performance, slowing disease progression, decrease in morbidity and mortality indicate the clinical efficacy of cardiac rehabilitation and make it an integral part of therapeutic interventions. Heart rehabilitation is a 1st class recommendation in the majority of modern cardiovascular guidelines around the world.

[Molecular mechanisms of adaptive and therapeutic effects of physical activity in patients with cardiovascular diseases]. / Molekulyarnye mekhanizmy adaptatsionnykh i lechebnykh effektov fizicheskikh nagruzok u patsientov s serdechno-sosudistymi zabolevaniyami.

Physical activity is one of the main components of the rehabilitation of patients with cardiovascular disease (CVD). As shown by practice and the results of evidence-based studies, the beneficial effects of physical activity on disease outcomes in a number of cardiac nosologies are comparable to drug treatment. This gives the doctor another tool to influence the unfavorable epidemiological situation in developed countries with the spread of diseases of the cardiovascular system and CVD mortality. Reliable positive results of cardiorehabilitation (CR) were obtained using various methods. The goal of CR is to restore the optimal physiological, psychological and professional status, reduce the risk of CVD and mortality. In most current CVD guidelines worldwide, cardiac rehabilitation is a Class I recommendation. The molecular mechanisms described in the review, initiated by physical activity, underlie the multifactorial effect of the latter on the function of the cardiovascular system and the course of cardiac diseases. Physical exercise is an important component of the therapeutic management of patients with CVD, which is supported by the results of a meta-analysis of 63 studies associated with various forms of aerobic exercise of varying intensity (from 50 to 95% VO2) for 1 to 47 months, which showed that CR based on physical exercise improves cardiorespiratory endurance. Knowledge of the molecular basis of the influence of physical activity makes it possible to use biochemical markers to assess the effectiveness of rehabilitation programs.

[The combined use of kinesio- and laser therapy in the regional hemodynamic disorders correction in dilated cardiomyopathy]. / Sochetannoe primenenie kinezo- i lazeroterapii v korrektsii narushenii regionarnoi gemodinamiki pri dilatatsionnoi kardiomiopatii.

The search for new methods of symptomatic therapy of dilated cardiomyopathy (DCM) remains a relevant objective of modern cardiology. This is due to the low and short-term existing methods effectiveness of conservative and surgical treatment, including drug therapy. PURPOSE OF THE STUDY: Efficacy evaluation of the combined use of kinesio- and laser therapy for the correction of regional hemodynamics in patients with DCM against the background of maintenance drug therapy. MATERIAL AND METHODS: 100 patients with DCM were examined. All patients received differential maintenance drug therapy (beta-blockers, ACE inhibitors, with intolerance to the latter - angiotensin II receptor blockers, aldosterone receptor antagonists, diuretics, cardiac glycosides, antiarrhythmic drugs). Patients were divided into 2 groups at least 3 months after the selection of drug therapy. Intravenous laser blood irradiation (ILBI) and the selection of unloading therapeutic exercises were performed for patients of the main group during therapy. Patients in the control group received only drug therapy. The main research method was venous occlusion plethysmography. It was used to assess regional hemodynamics with the determination of recirculating blood flow (Qr) and regional vascular resistance (Rr) at rest, venous tone (Vt), reserve blood flow (QH) and regional vascular resistance (RH) against a functional stress test. RESULTS: Data obtained in the dynamic observation process (after 1, 3, 6, 9 and 12 months) in the main group indicate a significant increase in Qr and QH, a decrease in Rr and RH, Vt. Significant positive dynamics in the control group was not observed. The regional hemodynamics indices after 9 and 12 months of observation significantly worsened. CONCLUSION: Thus, according to venous-occlusal plethysmography, the use of unloading therapeutic exercises in combination with ILBI against the background of rationally selected differentiated drug therapy in patients with DCM significantly improves the regional hemodynamics. The developed symptomatic therapy methods can be applied in the practice of cardiologists, general practitioners, therapeutists, rehabilitation physicians to optimize the treatment of patients with DCM.

[The effectiveness of comprehensive rehabilitation of the patients presenting with coronary heart disease with the application of underwater shower massage and electrical stimulation].

The underwater shower massage and electrical stimulation were applied to treat 120 patients presenting with coronary heart disease. The estimation of the effectiveness of this treatment with the use of functional diagnostic methods revealed its psychocorrective effect manifested in the form of reduced frequency and duration of painful and painless angina seizures, restricted sympathetic influences on the heart as well as normalized sympathovagal balance, lipid status, antioxidative system, central and peripheral hemodynamics, improved systolic and diastolic function of the myocardium, enhanced tolerability of mental, emotional, and physical workload. The study allowed the predictors of the effectiveness of therapeutic and health-promoting measures to be identified.

[Modern combined technologies for the rehabilitation of the patients presenting with arterial hypertension and its prevention].

The present review describes the modern methods for the combined treatment and rehabilitation of the patients presenting with arterial hypertension and their influence on the key pathogenetic components of this condition in accordance with the currently accepted theories of its origin and evolution. The discovery of specific molecular and cellular mechanisms of the therapeutic action of certain factors that reflect peculiar and unique character of their inherent physical energy provided a basis for the development of highly effective methods for the treatment and prevention of arterial hypertension and rehabilitation of the patients suffering this disease. The most comprehensive clinical effect is produced by the application of scientifically sound therapeutic systems; exclusion of certain therapeutic physical factors from these modalities results in s significant reduction of their curative effectiveness.

[The influence of carbon dioxide baths differing in the total mineralization levels on the functional state of the cardiovascular system of the patients presenting with hypertensive disease associated with coronary heart disease].

The results of the study on the influence of carbon dioxide baths differing in the total mineralization levels on the clinical course of hypertensive disease associated with coronary heart disease and on various functional systems of the body. The data obtained provide an insight into the role of salt concentrations (10 and 20 g/l) in carbon dioxide bath water (1.2 g/l) applied for the traditional treatment of the patients with hypertensive disease associated with concomitant coronary heart disease and musculoskeletal pathology. Highly mineralized bath water has a greater influence on the functional state of the cardiovascular system by causing a more pronounced decrease in peripheral vascular resistance and hypotensive effect. Baths with a salt concentration of 20 g/l markedly reduced pain and had anti-inflammatory effect in the patients with pathology of support and locomotor organs.

[Using diagnostic software module for monitoring the functional reserves of the organism for the estimation of the efficacy of health-improving and rehabilitative programs].

The social implications of the estimation of health reserves and their monitoring becomes increasingly important for early diagnostics of dysfunctional problems associated with the social and occupational activities as well as for the prevention of the development of pathological processes. Taking this fact into consideration, we have designed a diagnostic technology called "health reserves" for the identification of subjects with risk factors of the development of the most widespread diseases that enables the users to perform qualitative assessment of the risks, evaluate functional reserves of the organism, and prognosticate the efficacy of application of non-medicamental technologies for the improvement of the patients' health status. We studied 79 patients aged from 18 to 73 years including 33 (42.8%) men and 44 (57.2%) women at their admittance to the clinic and within 2-3 days after discharge. The patients were treated using non-medicamental rehabilitative techniques, such as remedial gymnastics, massage, iodine-bromine baths. The results of the treatment were subjected to the mathematical analysis. The study permitted to determine predictors of efficacy of the non-medicamental treatment and individualized rehabilitation programs.

[Estimation of the functional reserves of the organism and identification of the subjects at risk of common diseases].

The existing system of preventive medical examination of the population engaged in economic activities with the purpose of early diagnostics of a variety of disorders and pathological conditions practically does not use the technologies for the assessment of health reserves and identification of the groups at risk of developing common diseases and premorbid conditions. We examined a total of 67 subjects (32 men and 35 women) and treated the data obtained by using the mathematical methods of statistics. The results were used to develop the "Health Reserves" hardware and software complex whose diagnostic potential and informational content permit to identify individuals at high risk of developing common diseases, quantitatively evaluate functional reserves of the human organism, and predict the efficacy of application of non-medicamental technologies for their enhancement.

[The application of trans-auricular low-frequency electrical puncture for the treatment of arterial hypertension].

Clinical studies involving 67 patients with arterial hypertension (AH) have demonstrated that a single course of trans-auricular low-frequency electrical puncture produced a marked stress-relieving effect that was manifested as the decreased anxiety level, normalization of neurohumoral regulation of arterial pressure and central hemodynamics, improved tolerance of controlled psycho-emotional loading, beneficial effect on cerebral blood circulation, lipid and electrolyte metabolism. In addition, the proposed therapeutic modality resulted in substantial reduction of arterial pressure. Taken together, these observations give reason to consider it as a promising tool for the treatment of patients presenting with arterial hypertension.

[Potentials of combined non-medication therapy of arterial hypertension associated with ischemic heart disease].

The objective of the present work was to develop methods and a scientifically sound rationale for the optimization of clinical results of the treatment of patients presenting with arterial hypertension (AH) associated with coronary heart disease (CHD) using red and infra-red (IR) low-intensity laser irradiation. The study included a total of 90 patients of working age (62.2% of men and 37.8% of women) having AH associated with coronary heart disease and abnormal blood lipid spectrum. They were allocated to three groups each comprising 30 patients matched for age, sex, severity of clinical conditions, and character of maintenance medicamental therapy. Patients of group 1 were treated by intravenous blood irradiation with laser light; those in group 2 were given similar treatment in combination with external low-intensity IR laser therapy; patients of group 3 received basal medicamental therapy. The study allowed the clinical value of different variants of low-intensity laser therapy to be assessed as regards efficiency of correction of hypersympaticotony, disturbances of lipid metabolism, and refractoriness to pharmaceutical products as well as improved tolerance of physical exercises, anti-hypertensive, anti-ischemic, and anti-anginal effects, diastolic function, and quality of life as targets of the comprehensive rehabilitative program designed for patients with AH associated with coronary heart disease. An optimized therapeutic modality is proposed for patients presenting with these pathologies based on the application of the low-intensity laser irradiation regime characterized by mutual amplification and complementary action of red and infrared lights.

[Effect of peloid applications of different temperatures on the function of the cardiovascular system in patients with osteoarthrosis and concomitant hypertensive disease and ischemic heart disease].

This study investigated changes of systemic and intracardiac hemodynamics under effect of mud application at different temparatures (10, 20-24, and 36 degrees C) in patients with osteoarthrosis and concomitant hypertensive disease and coronary heart disease. It is concluded that combined treatment of this condition should include low-temperature peloidotherapy as a major component since it has the most beneficial effect on general and intracardiac hemodynamics.

Function of myocardial contraction and relaxation in essential hypertension in dynamics of acupuncture therapy.

Forty-nine patients with initial stages of essential hypertension (EH) were investigated using phase systole analysis and echocardiography during acupuncture (reflexotherapy) treatment. It was established that even at the initial stages of EH increasing of myocardial mass and the disturbances of contractile and diastolic activity of myocardium take place. As a result of acupuncture a stable hypotensive effect, improvement or normalization of contractile function and diastolic values, a decrease of energy loss, reversal of myocardial hypertrophy were achieved. It is the decrease of sympathetic influences on the circulation system that plays an important part in the onset of these positive changes.

[Functional changes of myocardial contraction and relaxation in hypertension patients as affected by reflexotherapy]. / Izmeneniia funkstii sokrashcheniia i rasslableniia miokarda u bol'nykh gipertonicheskoi bolezn'iu pod vliianiem refleksoterapii.

49 patients with initial stages of essential hypertension (EH) were investigated using phase systole analysis and echocardiography during acupuncture (reflexotherapy) treatment. It was established that even at the initial stages of EH increasing of myocardial mass and the disturbances of contractile and diastolic activity of myocardium take place. As a result of acupuncture a stable hypotensive effect, improvement or normalization of contractile function and diastolic values, a decrease of energy loss, reversal of myocardial hypertrophy were achieved. It is the decrease of sympathetic influences on the circulation system that plays an important part in the onset of these positive changes.

[Cerebral and autonomic aspects of labile hypertension]. / Tserebral'no-vegetativnye aspekty labil'noi gipertonii.

EEG, central hemodynamic parameters and the emotional syndrome were investigated in 55 patients with labile hypertension. Two cerebrovegetative patterns corresponding to different degrees of cortical activation and different mechanisms controlling arterial blood pressure and anxiety levels were identified. As the two groups of patients did not differ in terms of age or duration of the disease, those could not be attributed to different stages of the disease, suggesting rather that sympathetic and parasympathetic vegetative nervous components may be making different contributions to the formation of hemodynamic type.

[Cerebro-autonomic correlations in patients with early stages of hypertension during reflexotherapy]. / Tserebral'no-vegetativnye sootnosheniia u bol'nykh gipertonicheskoi bolezn'iu rannikh stadii v protsesse refleksoterapii.

Seventy patients with Stages I and II hypertensive disease underwent electrocardiographic studies of the emotional syndrome and central hemodynamics prior to and following reflexotherapy. Characteristics of the psychovegetative syndrome were identified in the patients. A significant antihypertensive effect and normalized psychological and vegetative parameters observed after reflexotherapy suggest that acupuncture is beneficial in the treatment at early stages of essential hypertension.

[Use of intragastric pH measurement in stomach cancer]. / Primenenie vnutrizheludochnoi pH-metrii pri rake zheludka.

The method of intragastric pH-metry was used to assess the acid production in the stomach in 35 patients with gastric tumors. All patients with malignant tumors were divided into two groups with respect to site: tumors in the cardia and corpus (18 cases) and tumors in the antrum and pylorus (17 cases). Continuous low-rate production of acid was registered. For cardial and corporal tumors, histamine-refractory anacidity predominated, while continuous low- and medium-rate production of acid was observed in cases of pylorantral tumors. The procedure proved especially effective in determination of gastric secretion in patients with stomach tumors because due to its application it was found that hydrochloric acid secretion continued under the conditions when other methods failed to detect it.

[Use of graded bicycle ergometry as a method for the objective evaluation of the efficacy of reflexotherapy in the early stages of hypertension]. / Ispol'zovanie dozirovannoi veloérgometricheskoi nagruzki kak matoda ob"ektivnoi ostenki éffektivnosti refleksoterapii rannikh stadii gipertonicheskoi bolezni.

Graded bicycle ergometry was used to evaluate the efficacy of pathogenetic auriculo-paravertebral reflexotherapy (RT) in 24 patients with stages IB and IIA of essential hypertension (EH). After RT was completed the subjective symptomatology, central hemodynamics, and heart work improved. The increment of the minute volume of the circulation in response to graded exercise decreased, especially in patients with stage IB of EH. These patients also showed a reduction in the heart rate. The total peripheral vascular resistance dropped both at rest and after exercise. After RT the patients with stages IB and IIA of EH manifested a decrease in the loading heart index and intensity of the functioning of the structures, with that decrease being more demonstrable in patients with stage IIA EH, which attested to the lowering of heart muscle oxygen consumption. The decreased intensity of the functioning of the structures in patients with stage IB EH points to the diminution of myocardial hyperfunction marking the hyperkinetic circulatory pattern in these patients.

[The effect of acupuncture on the hemodynamics and tolerance for physical loads in patients with cardiovascular diseases]. / Vliianie akupunktury na gemodinamiku i tolerantnost' k fizicheskim nagruzkam u bol'nykh s serdechno-sosudistymi zabolevaniiami.

Discontinuation of chemotherapy substituted for a course of acupuncture and electroacupuncture in 124 patients with coronary heart disease, essential hypertension and neurocirculatory dystonia resulted in a positive response of cerebral and peripheral hemodynamics, myocardial contractility and diastolic function. Myocardial hypertrophy regressed, exercise tolerance enhanced. Reflex activation of stress-limiting systems arresting excess adrenergic action on circulation is probably responsible for these phenomena.

[Submerged hydromassage as a method for the rehabilitation of myocardial infarct patients at the polyclinic stage]. / Podvodnyi gidromassazh kak metod reabilitatsii bol'nykh infarktom miokarda na poliklinicheskom étape.

The studies in postmyocardial infarction patients have shown that underwater massage is an effective method of conditioning of the above patients in outpatient setting. Its positive action on cardiovascular system has improved clinical condition of 70% of those treated. Episodes of angina pectoris disappeared or became less frequent, the pains attenuated, exercise tolerance enhanced. 66.7% of the patients retained the effect for 6 months, 53.3% for 12 months. The results obtained allowed the authors to recommend underwater massage as an effective rehabilitation method for early and late management of postmyocardial infarction outpatients.

[The effect of contrast baths on central nervous system function in patients with a disordered menstrual function]. / Vliianie kontrastnykh vann na funktsional'noe sostoianie tsentral'noi nervnoi sistemy u bol'nykh s narusheniem menstrual'noi funktsii.

EEG, REG, psychoemotional tests have been performed in 26 females of reproductive age suffering from neuroendocrine syndrome with dysmenorrhea. The findings were indicative of defects in cerebral function and circulation. This confirms contribution of the central nervous system to the onset of their disease. The treatment with contrast baths resulted in recovery of mechanisms of cerebral regulation as seen from attenuation of clinical symptoms, positive changes in psychoemotional status, EEG and REG.