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New algorithm for proper patients’ selection and risk stratification aimed to efficient aerobic cardiorespiratory training after coronary artery bypass grafting

Authors: Kakuchaya T.T., Tokaeva Z.K., Dzhitava T.G.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2020-14-4-324-338

For citation: Kakuchaya T.T., Tokaeva Z.K., Dzhitava T.G. New algorithm for proper patients’ selection and risk stratification aimed to efficient aerobic cardiorespiratory training after coronary artery bypass grafting. Creative Cardiology. 2020; 14 (4): 324–38 (in Russ.). DOI: 10.24022/1997-3187-2020-14-4-324-338

Received / Accepted:  09.12.2020 / 16.12.2020

Keywords: aerobic cardiorespiratory training coronary artery bypass grafting ergospirometry, peak oxygen consumption, RARE scale, risk stratification protocol, survival

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Abstract

Aim – to develop an intrinsic model of patients’ selection before recommending moderate or high intensity aerobic cardiorespiratory trainings based on the level of peak oxygen consumption.

Materials and methods. One hundred thirty seven patients were included to our study in order to create a novel protocol of proper selection and risk stratification before starting aerobic cardiorespiratory trainings 4 weeks after coronary artery bypass grafting. RARE scale (risk of activity related events), ergospirometric test, FIT-treadmill score and certain laboratory parameters were used. This comprehensive protocol provides safe and efficient cardiac rehab training program for different groups of patients. Advantage of our protocol is that it reveals logical interdependence between certain indicators of cardiorespiratory capacity and risk of developing unfavorable events, and allows assessing long-term survival in actively trained and not trained patients.

Conclusion. Based on multifactorial regression analysis algorithm of patients selection after coronary artery bypass surgery should include METs, RARE scale, FIT-treadmill score, left ventricular ejection fraction, hemoglobin and alaninaminotransferase levels. This kind of protocol allows to differentiate patients’ into low, middle and high class of readiness to physical activities, including aerobic cardiorespiratory training programs.

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About Authors

  • Tea T. Kakuchaya, Dr. Med. Sc., Head of Department, ORCID
  • Zarina K. Tokaeva, Cardiologist, ORCID
  • Tamara G. Dzhitava, Cand. Med. Sc., Deputy Head of Department, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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