PMID- 38088111
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231216
IS  - 0022-9040 (Print)
IS  - 0022-9040 (Linking)
VI  - 63
IP  - 11
DP  - 2023 Dec 5
TI  - Tolerability of an Individualized Physical Rehabilitation Program in Patients 
      Dependent on Inotropic Support With End-Stage Chronic Heart Failure.
PG  - 36-45
LID - 10.18087/cardio.2023.11.n2528 [doi]
AB  - Aim      To assess the tolerability of an individualized physical rehabilitation 
      program (PRP) in inotrope-dependent patients with end-stage chronic heart failure 
      (CHF).Material and methods  This prospective randomized study included 120 men 
      aged 18-65 years with left ventricular ejection fraction </=30 % and blood pressure 
      >/=90 / 60 mm Hg. Patients who have received dobutamine or dopamine for >/=2 weeks 
      were randomized into two groups: group 1, 40 patients who participated in the PRP 
      and group 2, 40 patients who did not participate in the PRP. Group 3 included 40 
      patients without inotropic support who participated in the PRP.Results Patients 
      of groups 1 and 3 attended &gt;80 % of the scheduled classes without developing 
      life-threatening adverse events (AEs) associated with exercise (E). After 6 
      months of the study, the exercising patients achieved a comparable (average) E 
      intensity: 44 [35; 50]% and 45 [40;52]% of heart rate reserve and Borg scale 
      scores 14 [12; 14] and 13 [11; 14] in groups 1 and 3, respectively (p&gt;0.05). 
      Initially, after 3 and 6 months at the peak of physical activity in groups 1 and 
      3, there was no decrease in arterial blood oxygen saturation according to pulse 
      oximetry (SpO2) &lt;93 %. At baseline, lactate levels in central venous blood at 
      rest were normal in all groups. After 6 months, the lactate concentration was 1.1 
      mmol / l in group 1, 2.3 mmol / l in group 2, and 1.4 mmol / l in group 3 
      (small er, Cyrillic1-2=0.005; p2-3=0.008, respectively). At the E peak at baseline, after 3 and 6 
      months, comparable increases in lactate not exceeding 3 mmol / l were detected in 
      groups 1 and 3.Conclusion      The study allowed assessment of the tolerability 
      of individualized PRP performed at the aerobic level of energy supply, in 
      inotropic-dependent patients with CHF. Individualized 6-month PRP in 
      inotropic-dependent patients with end-stage CHF, provided safety criteria are 
      met, is well tolerated and does not increase the number of AEs associated with 
      CHF and physical rehabilitation (PR). Continued inotropic support with dopamine 
      or dobutamine should not be considered as a contraindication to PR in patients 
      with CHF in the absence of E intolerance or life-threatening AEs.
FAU - Bortsova, M A
AU  - Bortsova MA
AD  - Almazov National Medical Research Center, St-Petersburg.
FAU - Demchenko, E A
AU  - Demchenko EA
AD  - Almazov National Medical Research Center, St-Petersburg.
FAU - Fedotov, P A
AU  - Fedotov PA
AD  - Almazov National Medical Research Center, St-Petersburg.
FAU - Ganenko, O S
AU  - Ganenko OS
AD  - Almazov National Medical Research Center, St-Petersburg.
FAU - Osipova, M A
AU  - Osipova MA
AD  - Almazov National Medical Research Center, St-Petersburg.
FAU - Korneva, L O
AU  - Korneva LO
AD  - Almazov National Medical Research Center, St-Petersburg.
FAU - Musaeva, B B
AU  - Musaeva BB
AD  - Almazov National Medical Research Center, St-Petersburg.
FAU - Sazonova, Yu V
AU  - Sazonova YV
AD  - Almazov National Medical Research Center, St-Petersburg.
FAU - Simonenko, M A
AU  - Simonenko MA
AD  - Almazov National Medical Research Center, St-Petersburg.
FAU - Sitnikova, M Yu
AU  - Sitnikova MY
AD  - Almazov National Medical Research Center, St-Petersburg.
LA  - rus
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20231205
PL  - Russia (Federation)
TA  - Kardiologiia
JT  - Kardiologiia
JID - 0376351
RN  - 3S12J47372 (Dobutamine)
RN  - VTD58H1Z2X (Dopamine)
RN  - 0 (Cardiovascular Agents)
RN  - 0 (Lactates)
SB  - IM
MH  - Male
MH  - Humans
MH  - *Heart Failure
MH  - Dobutamine/therapeutic use
MH  - Stroke Volume
MH  - Dopamine/therapeutic use
MH  - Prospective Studies
MH  - Ventricular Function, Left
MH  - *Cardiovascular Agents/therapeutic use
MH  - Lactates/therapeutic use
EDAT- 2023/12/13 06:42
MHDA- 2023/12/17 09:45
CRDT- 2023/12/13 04:23
PHST- 2023/06/05 00:00 [received]
PHST- 2023/07/31 00:00 [accepted]
PHST- 2023/12/17 09:45 [medline]
PHST- 2023/12/13 06:42 [pubmed]
PHST- 2023/12/13 04:23 [entrez]
AID - 10.18087/cardio.2023.11.n2528 [doi]
PST - epublish
SO  - Kardiologiia. 2023 Dec 5;63(11):36-45. doi: 10.18087/cardio.2023.11.n2528.