title: [The impact of cardiac rehabilitation on selected hemodynamic parameters and risk in patients with heart failure].
abstract: Due to the aging of the population is an increase in the incidence of heart failure. Progress in the treatment of cardiovascular disease determines the development of cardiac rehabilitation, which in addition to drug therapy, dietary and psychotherapy plays an important role promoting physical activity The aim of this study was to evaluate the impact of cardiac rehabilitation on the process of treatment and prognosis in patients with heart failure.
  
  
  METHODS
  The study included 23 women and 46 men, aged 40-74 years (mean age 58.6 ± 8.1 years) with a diagnosis of heart failure, Class I-III NYHA. All were qualified forthe second stage of rehabilitation. The period of stay in the hospital was 2-4 weeks. Patients were divided into 3 groups: group I population of 19 patients (59.2 ± 8.3 years) participated in a 2-week rehabilitation program, group II representing 29 patients (55.3 ± 7.9 years) in 4-week program. In Group III--reference (21 patients, mean age 65.4 ± 8.2), due to the high risk of using individual cardiac rehabilitation program adapted to the patients. All patients underwent submaximal exercise test. In groups I and II to assess the level of physical fitness, a standard Bruce protocol, while in group III, its modified form. Blood pressure and resting heart rate were also studied. To assess the risk of patients the Duke's indicator was used. Systolic function of the left ventricle were evaluated in echocardiography. After a period of 6 months from the end of the second phase of cardiac rehabilitation, 24 patients who agreed were repeated the whole range of clinical trials conducted in the course of rehabilitation.
  
  
  RESULTS
  In the group that received the cardiac rehabilitation based on interval training, after completion of the program, there was a statistically significant increase in EF, while reducing the level of blood pressure and pulse rate. The risk assessment of patients undergoing rehabilitation showed the greatest changes in group II, which after rehabilitation were classified as low risk. After a period of six months from the end of the second stage of rehabilitation analysis of individual parameters showed a further, significant improvement in groups I and II, with the highest rate of change between the studied parameters throughout the study period was observed in group II--subjected to a longer period of rehabilitation.
  
  
  CONCLUSIONS
  The rehabilitation gives the favorable effect on the healing process in patients with heart failure by reducing the risk of patients undergoing systematic training.
authors.forename: Robert
authors.initials: R
authors.lastname: Irzmański
authors.forename: Joanna
authors.initials: J
authors.lastname: Kapusta
authors.forename: Anna
authors.initials: A
authors.lastname: Kapusta
authors.forename: Jan
authors.initials: J
authors.lastname: Kowalski
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging