Bohumil Fišer

TWENTY FOUR-HOUR PROFILE OF BLOOD PRESSURE AFTER 60-MINUTES LASTING CARDIAC EXERCISE TRAINING IN PATIENTS AFTER MYOCARDIAL INFARCTION: PP.14.22

Objective: The aim of the study was to compare 24-hour course of blood pressure immediately after the exercise training with the values from the following day when the patients after myocardial infarction did not exercise. Method: The group being monitored consisted of 23 patients after myocardial infarction of the age 63 ± 6.3 years and ejection fraction 43 ± 12.3 %. In the course of cardiac rehabilitation (aerobic and resistance training, lasted 60 minutes), the patients were subjected to 7-day ambulatory blood pressure monitoring (AD TM2421 Japan). During 7-day blood pressure monitoring their pharmacotherapy was not interrupted and consisted of ACE inhibitors, betablockers and statins. Results: The mean values of 24-h blood pressure profile (systolic ad diastolic) did not differ between the day with exercises and the day without exercise (120 ± 9 versus 120 ± 8mmHg, 72 ± 8 versus 72 ± 8mmHg). Comparison of hour differences in systolic and diastolic blood pressure indicated that only in the first hour after the exercises training the systolic pressure is lower than in the check course (120 + 4 mmHg versus 125 + 3 mmHg, p < 0.01). Also in the second hour after the exercises the value is lower, the difference, however, is not statistically significant any more. In the other hours both profiles were not different. We have found no differences in diastolic pressure. Conclusion: The analysis of 24-hour profile of systolic and diastolic blood pressure showed that the exercise training change systolic blood pressure only one hour immediately after the exercises.

Interval and continuous training in cardiovascular rehabilitation

The objective of the study was to evaluate the physiological effectiveness and the influence of two modifications of aerobic training (interval and continuous) on the physical performance in the patients with coronary heart disease. 38 males with coronary heart disease (age 60 +/- 10.2 years) passed three months training programme of 60 min 3 times a week (10 min of warm up phase, 25 min of aerobic phase, 15 min of resistance training, 10 min of relaxing phase). Patients with coronarographically verified stenosis > 50% luminal diameter and/or left ventricular ejection fraction lower than 40 % (n = 22) had in terms of aerobic phase interval training prescribed (30 second work phases with work load intensity on the level of anaerobic threshold alternating with 60 second recovery phases with intensity of 5 W); other patients (n = 16) passed aerobic phase of the programme with continual work load of intensity on the level of ventilatory anaerobic threshold. After the determination of three month rehabilitation programme the maximal achieved performance as well as aerobic capacity evaluated by spiroergometric examination statistically significantly increased in the group of patients with interval training and also in the group with continuous training. Despite the group with interval training performed 2.5-3 times less work in each training unit (p < 0.01), the performance and aerobic capacity parameters after the termination of three month programme did not statistically significantly differ from the group with continuous training. The advantage of the continuous training is a possibility to achieve an improvement also in the patients with left ventricular dysfunction and chronic coronary heart disease who could have worse tolerance of the continual work load.