The prospects for NT-pro BNP level determining in physical activity conditions in patients during the rehabilitation period after the myocardial infarction, complicated with decompensated heart failure

Abstract

The aim of the study was to determine the futility of NT-pro BNP level analysis during dosed physical exercise for diagnosing decompensated HF in the postinfarction period and the possibility to determine the HF functional class. Materials and methods. 160 patients with previous MI were examined, patients’ average age was (56.67±5.72) years. The patients were randomized in 2 groups dependently on the presence of the signs of II А-B according to V. Kh. Vasylenko and M. D. Strazhesko classification and FC III-IV (according to NYHA) decompensated chronic HF. Group I consisted of 120 patients with Q-QS and non-Q MI; group II (the control one) had 40 patients with MI without signs of decompensated HF; 20 healthy people made up a norm group. Results. Signs of coronary insufficiency such as dizziness and signs of poor peripheral perfusion (cyanosis/paleness) occurred in 104 (86.7 %) and 79 (65.8 %) cases that differ from the same values in the second group 4 (10.0 %) and 14 (35.0 %) respectively. 88 (73.3 %) patients with the signs of decompensated HF felt general weakness, fatigue, and expressed a request to stop the test. The HR in the postinfarction patients with the signs of decompensated HF was before the exercise (88.2±3.18) bpm (p≤0.05); in the patients with past MI without the signs of decompensated HF, it was (75.32±3.41) bpm (p≤0.05); and in the practically healthy people, it was (77.73±3.02) bpm. We found out a reverse moderate correlation between the distances that had been covered by a patient during the 6MWT NT-proBNP level in blood serum of examined patients. Conclusions. Inadequate response to dosed physical exercises and increased immunological parameters as quantitative HF markers could be useful not only for diagnostics, but also for the risk stratification for decompensated HF that had occurred in patients on different rehabilitation stages after an acute MI.