Perm Medical JournalPerm Medical JournalПермский медицинский журнал (сетевое издание "Perm medical journal")0136-14492687-1408Eco-Vector9576210.17816/pmj38485-103Literature reviewОбзор литературыReview ArticleRehabilitation of patients with chronic heart failure: opportunities and unresolved issuesРеабилитация больных хронической сердечной недостаточностью: возможности и нерешенные проблемыVladimirskiyV. E.ВладимирскийВ. Е.
Russian Federation

MD, PhD, Associate Professor Department of Faculty Therapy № 1

доктор медицинских наук, доцент кафедры факультетской терапии № 1

vladimirskii_v@mail.ruBobylevYu. M.БобылевЮ. М.
Russian Federation

Candidate of Medical Sciences, Associate Professor of Departament of Propedeutics of Internal Diseases

кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней № 1

vladimirskii_v@mail.ruE.A. Vagner Perm State Medical UniversityПермский государственный медицинский университет имени академика Е.А. Вагнера15082021384851030101202201012022Copyright ©; 2021, Vladimirskiy V.E., Bobylev Y.M.Copyright ©; 2021, Владимирский В.Е., Бобылев Ю.М.2021Vladimirskiy V.E., Bobylev Y.M.Владимирский В.Е., Бобылев Ю.М.http://creativecommons.org/licenses/by-sa/4.0https://permmedjournal.ru/PMJ/article/view/95762

The review is devoted to the problem of rehabilitation of patients with chronic heart failure (CHF). About 7 % of the population of our country have confirmed CHF. This fact is a reason for serious concern since this pathology is the main cause of death of patients from cardiovascular diseases. Until the end of the 20th century, the presence of symptomatic CHF in a patient was a contraindication for physical rehabilitation. However, over the past 10-15 years, rehabilitation care for this category of patients has been recommended by many medical communities. This review provides data on the mechanisms of the effect of physical activity on patients with CHF. Much attention is paid to clinical studies and meta-analyzes, which assess the clinical effectiveness of cardiac rehabilitation (CR) in patients with CHF. It has been shown that the effectiveness of this aid differs in different groups of CHF patients. Attention is paid to the description of the CR methodology among patients with CHF. Alternative opinions of the authors on the effectiveness of different types of training regimes are presented, methods for assessing the intensity of physical exercises are described. The review provides data on different models of organizing the delivery of rehabilitation care to CHF patients.

Обзор посвящен проблеме реабилитации пациентов с хронической сердечной недостаточностью (ХСН). Около 7 % населения нашей страны имеют подтвержденную ХСН. Этот факт является основанием для серьезного беспокойства, так как данная патология полагается основной причиной смерти больных от сердечно-сосудистых заболеваний. До конца ХХ в. наличие у пациента симптомной ХСН являлось противопоказанием для физической реабилитации. Однако в течение последних 10–15 лет реабилитационная помощь данной категории пациентов рекомендуется многими врачебными сообществами. В обзоре приводятся данные о механизмах влияния физических нагрузок на больных ХСН. Большое внимание уделено клиническим исследованиям и метаанализам, оценивавшим клиническую эффективность кардиореабилитации больных ХСН. Показано, что эффективность данной помощи отличается в разных группах больных ХСН. Уделено внимание описанию методологии кардиореабилитации у пациентов с ХСН. Приводятся альтернативные мнения авторов об эффективности разных типов режимов тренировок, описываются методы оценки интенсивности физических упражнений. В обзоре приводятся данные о разных моделях организации доставки реабилитационной помощи больным ХСН.

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