[Selection of optimal training exercise and training schedule for patients with ischemic heart disease at the early periods after aortocoronary bypass]. / O vybore optimal'noi treniruiushchei nagruzki i treniruiushchego pul'sa u bol'nykh ishemicheskoi bolezn'iu serdtsa v rannie srokiposle operatsii aortocoronarnogo shuntirovaniia.

The study was undertaken to examine 70 patients with coronary heart disease who had undergone aortocoronary bypass. Spirobicycle ergometric testing was performed in all patients in the early postoperative period, coupled with recording hemodynamic parameters, such as cardiac and stroke indices, heart rate, and Q-Z interval, by employing tetrapolar rheoplethysmography. According to the results of threshold exercise, the patients were divided into three groups: those having threshold exercise intensities of 100, 75, and 50 W, respectively. The purpose of the study was to choose the optimal training pulse and training exercise in the early postoperative period of rehabilitation. Using various procedures for determining the training pulse from the threshold of anaerobic exchange, from 70% maximal oxygen uptake and from hemodynamic findings demonstrated that hemodynamic monitoring is the most informative tool since in the early postoperative periods of aortocoronary bypass, the results of threshold exercise are largely determined by the myocardial contractility that is associated with the overall body dysadaptation and, accordingly, the cardiopulmonary system and with the impact of the surgery itself involving extracorporeal circulation.