Оценка возможности улучшения функциональных резервов у больных инфарктом миокарда с коморбидной пульмонологической патологией в процессе реабилитации

Аннотация

The development of medical technologies and consequent aging of population requires multidisciplinary approaches in treating patients with myocardial infarction, as the number of comorbid pathologies usually increases with age. Comorbid pathology significantly complicates the process of diagnosis and treatment, results in patients disability, impedes adequate rehabilitation. The purpose of the given research was to analyze the relationship between pulmonary comorbidity and functional parameters of patients with myocardial infarction. 371 patients with acute myocardial infarction, who were undergoing inpatient stage of recovery, were examined. Entry criteria included: confirmed diagnosis of acute myocardial infarction and written informed consent of patients to participate in the study. Exit criteria included: psychiatric disorders, diseases of internal organs at the decompensation stage, as well as the presence of hemodynamically significant heart defects. The patients’ age was 66.16± 10.41 years. Of the patients participating in the research, 67.12% were male and 32.88% were female. Results and discussion. The development of myocardial infarction with underlying comorbid pulmonary pathology has its clinical and hemodynamic peculiarities, often complicated by left ventricular failure, and also has a tendency to the emergence of Dressier's syndrome, which aggravates the therapeutic process and limits the possibilities of rehabilitation. Limiting factors that significantly reduce the functionality of patients with myocardial infarction in combination with pulmonary pathology are smoking status, mitral and tricuspid valve regurgitation, elevated pulmonary artery pressure, as well as the Charlson Comorbidity Index. Smoking contributes to a significant deterioration of functional reserves in patients with myocardial infarction and pulmonary comorbidity, therefore, an indispensable part of the rehabilitation of these patients must be programs aimed at helping smokers to quit.