Nazarenko L.N., Mkrtchjan R.I., Shapovalova V.I.

NUZ «Sanatorium» the Narzan Valley «, Open Society RZHD,
Kislovodsk, Russia

dolina_plan@mail.ru

The purpose of research: To study influence of complex sanatorium treatment in low-mountain conditions of Kislovodsk on patients with ischemic heart disease (IHD) with a stenocardia at presence of pre-excitation syndromes ventricle (PES) extra systolic and ectopic genesis, and also late ventricular potentials (LVP). Under supervision there were 195 patients (IHD) with a stenocardia of pressure I, II functional class (138-males, 57-females), middle age 57,7 ± 13,3 years. Duration of treatment — 20,2 ± 1,5 days. In the beginning and the end of treatment carrying out researches: an electrocardiogram in 12 assignments (removals), 24 hour monitoring of an electrocardiogram, cycle-ergometry, fixing LVP on the device — «Cardio Soft 3.0» (Germany), examining anticoagulant blood system, the findings of lipid and a carbohydrate exchange. Results: at all patients infringements of a rhythm on type supraventricular and the ventricular extra systolia were observed in all groups. From 126 patients with the ventricular extra systole at 102 (64,2%) they had the fixed communication with previous activation of heart, at 24 (12,2%) parasistoliya, at 48 had the paroxysms of atrial fibrillation. According to an electrocardiogram 67 patients had attributes of an ischemia of a myocardium (34,1%), a heart attack of a myocardium prescription from 2 till 12 years — at 25 sick (12,8 %). Arterial hypertension — at 134 person (68,7%). Late ventricular potentials are established at 46 sick (23,6 %), were registered more often at men with the burdened current of disease — the transferred heart attack of a myocardium, presence ectopic centers PEC (ratio) of 42,8% — 8,1 %). At 90 % in the first week of stay in sanatorium, during the basic adaptation, II impellent mode, walks on 1 and 2 routes the terrenkur, integral carbonic baths, if necessary physiotherapy was appointed I, later. In result of sanatorium-resort treatment at 90% of patients, attacks of a stenocardia it were not observed or marked their appreciable reduction seizure. At patients with an ischemia of a myocardium improvement of processes of repolarization has come in 56,8%, at 50% — normalization. At 4 patients aggravation of infringement of processes of repolarization took place. Full disappearance of infringements of a rhythm took place at 45 % of patients, reduction −46,2 %. A comparative estimation on clinical semiology and the data of functional methods of research testified to lower efficiency of resort treatment at patients with the burdened current of disease: the transferred heart attack of a myocardium with presence parasistoliya, or LVP. From 4 person with an estimation without changes at 3 were available LVP, for two myocardiums transferred a heart attack and ectopic centers LVP. In a result 195 patients 190 person (97,4 %) have left with an estimation «improvement», without improvement 5 person (2,5 %).

Conclusions:

1. Complex sanatorium treatment in low-mountain conditions Kislovodsk is shown patients IHD with a stenocardia of pressure I, II functional class at presence of infringements of a rhythm extra systolic genesis.

2. With the transferred heart attack of a myocardium at presence ectopic centers of excitation and LVP treatment on mountain resorts is not shown patients IHD.