CLINICAL ANAMNESTIC CHARACTERISTICS AND MUSCLE STRENGTH IN MIDDLE-AGED MEN WITH ISCHEMIC HEART DISEASE IN THE PRESENCE OF MYOCARDIAL INFARCTION

Introduction. Evaluation of muscle strength of wrist flexors in patients with coronary heart disease can act as a predictor of total muscle strength and influence the prognosis for patients after a previous myocardial infarction, taking into account the rehabilitation program.

The purpose of the study is comparison of clinical anamnestic characteristics of middle-aged men with coronary heart disease with comparable social status, physical activity and body mass index (BMI), depending on the presence of myocardial infarction as well as an assessment of muscle strength of the wrist flexors, bioelectrical impedance analysis and testosterone level.

Material and Methods. The study included men at the age of 58.09±6.85 on average; living in rural areas who were clinically monitored by a cardiologist at the central district hospital: the main group included men 3 months after the first myocardial infarction, the comparison group — patients with stable coronary heart disease. Clinical anamnestic status of all patients was assessed; evaluation of muscle strength of wrist flexors by means of dynamometry, bioelectrical impedance analysis, testosterone test and SF-36 Survey were also carried out.

Results. Middle-aged men (58.09±6.85 years old) living in rural areas who had a similar physical activity, a long anamnesis of hypertension 180 (72; 228) months, coronary heart disease (49.28±12.47 months), anamnesis of coronary artery bypass surgery — CABG (1.2±0.03 years) were more likely to have hereditary cardiovascular diseases (38 vs. 12% , p=0.05) and anamnesis of previous acute disturbance of cerebral circulation (16 vs. 2%, p=0.04) than patients after the first myocardial infarction. The 6-minute walk test was greater in men after the first myocardial infarction (457.07±46.44 vs. 416.64±51.58, р<0.05), they had higher indexes of physical — 70 (55; 80) scale against to 55 scale (25; 65, р<0.02) and social functioning — 75 (62.5; 100) vs. 62.5 (50; 75, p<0.05), energy level was 55 (50; 75) scale to 50 (45; 60) scale (p<0.05) and mental health 62 (52; 77) to 52 (52; 60) scale with (p<0.01). Regardless of the duration of IHD or the presence of the first myocardial infarction, middle-aged men with overweight who had the same correlation of muscle and adipose tissue and testosterone level showed comparable strength of wrist flexors, measured by means of a dynamometer.

1. Аронов Д. М., Оганов Р. Г. Кардиологическая реабилитация в России — проблемы и перспективы. Российский кардиологический журнал. 2001; 3: 4–9 [Aronov D. M., Oganov R. G. Cardiological rehabilitation in Russia — problems and prospects. Russian Cardiology Journal. 2001; 3: 4–9] (In Russ). DOI:10.15829/1560-4071-2001-3-4-9.

2. Аронов Д. М., Бубнова М. Г., Барбараш О. Л., Долецкий А. А., Красницкий В. Б., Лебедева Е. В., Ямина Н. П., Репин А. Н., Свет А. В., Чумакова Г. А. Российские клинические рекомендации: реабилитация и вторичная профилактика у больных, перенесших острый инфаркт миокарда с подъемом сегмента ST. Журнал Кардиосоматика. 2014; 1: 5–42 [Aronov D. M., Bubnova M. G., Barbarash O. L., Doletsky A. A., Krasnitsky V. B., Lebedeva E. V., Jamina N. P., Repin A. N., Svet A. V., Chumakova G. A. Russian clinical recommendations: rehabilitation and secondary prevention in patients who underwent acute myocardial infarction with ST segment elevation. Journal of Cardiosomatics. 2014; 1: 5–42] (In Russ).

3. Бокерия Л. А., Аронов Д. М., Барбаш О. Л., Бубнова М. Г., Князева Т. А., Лямина Н. П. Маликов В. Е., Новикова Н. К., Петрунина В. Е., Арзуманян М. А., Сумин А. Н., Чумакова Г. А. Российские клинические рекомендации: коронарное шунтирование больных ишемической болезнью сердца: реабилитация и вторичная профилактика. Журнал Кардиосоматика. 2016; 7: 3–4 [Bokeria L. A., Aronov D. M., Barbash O. L., Bubnova M. G., Knyazeva T. A., Lyamina N. P. Malikov V. E., Novikova N. K., Petrunina V. E., Arzumanjan M. A., Sumin A. N., Chumakova G. A. Russian clinical recommendations: coronary bypass surgery for patients with ischemic heart disease: rehabilitation and secondary prevention. Journal of Cardiosomatics. 2016; 7: 3–4] (In Russ).

4. Бубнова М. Г., Аронов Д. М. Методические рекомендации. Обеспечение физической активности граждан, имеющих ограничение в состоянии здоровья. Под редакцией С. А. Бойцова. Журнал Кардиосоматика. 2016; 7(1): 5–50 [Bubnova M. G., Aronov D. M. Methodological recommendations. Ensuring the physical activity of citizens who have a restriction in the state of health. Edited by S. A. Boytsov. Journal of Cardiosomatics. 2016; 7(1): 5–50] (In Russ).

5. Gariballa S., Alessa A. Sarcopenia: Prevalence and prognostic significance in hospitalized patients. Clin. Nutr. 2013; 30: 27–32.

6. Шальнов М. А. Реабилитация после инфаркта миокарда. М.: Научная книга; 2008: 339 [Shalnov M. A. Rehabilitation after myocardial infarction. Moscow: The scientific book, 2008: 339] (In Russ).

7. Newman A. B., Kupelian V., Visser M., Simonsick E. M., Goodpaster B. H., Kritchevsky S. B., Tylavsky F. A., Rubin S. M., Harris T. B. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J. Gerontol. A Biol. Sci. Med. Sci. 2006; 61(1): 72–77.

8. Patrick R. Lawler, M.D., Kristian B. Efficacy of Exercise-based Cardiac Rehabilitation Post–myocardial Infarction. A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Filion Am. Heart J. 2011; 162(4): 571–584.

9. Charlson M. E., Pompei P., Ales K. L., MacKenzie C. R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J. Chron. Dis. 1987; 40: 373–383.

10. Kapoor J. R., Heidenreich P. A. Obesity and survival in patients with heart failure and preserved systolic function: a U-shaped relationship. Am. Heart J. 2010; 159(1): 75–80.

11. Турова Е. А. Мышечная ткань и старение. Журнал Вестник эстетической медицины. 2013; 12(1): 58–62 [Turova E. A. Muscular tissue and aging. Journal of Herald of Aesthetic Medicine. 2013; 12(1): 58–62] (In Russ).

12. Laurentani F., Russo C., Bandinelli S., Bartali B., Cavazzini C., Di Iorio A., Corsi A. M., Rantanen T., Guralnik J. M., Ferrucci L. Ageassociated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J. Appl. Physiol. 2003; 95: 1851–1860.

13. Зарудский А. А., Прощаев К. И. Старческая астения и сердеч- но-сосудистые болезни как факторы взаимоотягощения. Журнал современные проблемы науки и образования. 2014; 1: 131 [Zarudsky A. A., Proshchaev K. I. Starch asthenia and cardiovascular diseases as factors of mutual engagement. Journal of Contemporary Problems in Science and Education. 2014; 1: 131] (In Russ).

14. Зарудский А. А., Прощаев К. И., Ильницкий А. Н., Перуцкая Е. А. Современные взгляды на диагностику старческой астении. Журнал Современные проблемы науки и образования. 2015; 4 [Zarudsky A. A., Proshchaev K. I., Ilnitsky A. N., Perutskaya E. A. Modern views on the diagnosis of senile asthenia. Journal Modern problems of science and education. 2015; 4] (In Russ).

15. Guralnik J. M., Ferrucci L., Pieper C. F., Leveille S. G., Markides K. S., Ostir G. V., Studenski S., Berkman L. F., Wallace R. B. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J. Gerontol. A Biol. Sci. Med. Sci. 2000; 55: M221–31.

16. Pierson L. M., Miller L. E., Pierson M. E., Herbert W. G., Cook J. W. Validity of hand-held dynamometry for strength assessment in cardiac rehabilitation. J. Cardiopulm. Rehabil. 2005; 25(5): 266–269.

17. Еликов А. В. Метаболическая адаптация к двигательной ак- тивности различной интенсивности и гиподинамии: дис. … д-ра мед. наук. Киров, 2014: 44 [Elikov A. V. Metabolic adaptation to motor activity of various intensity and hypodynamia. Dr. med. sci. diss. Kirov. 2014: 44] (In Russ).

18. Носков С. Н., Бридерс А. А., Лаврухина А. А., Гульнева М. Ю., Цурко В. В. Клиническое значение саркопении и миопении. Русский Медицинский Журнал. 2013; 21: 1041 [Noskov S. N., Breeders A. A., Lavrukhina A. A., Gulneva M. Yu., Tsurko V. V. Clinical significance of sarcopenia and myopia. Russian Medical Journal. 2013; 21: 1041] (In Russ).

19. Azimi A., Charlot M. G., Torp-Pedersen C. Gislason G. H., Køber L., Lisette Okkels Jensen L. O., Thayssen P., Ravkilde J., Tilsted H-H., Lassen J. F., Thuesen L. Moderate overweight is beneficial and severe obesity detrimental for patients with documented atherosclerotic heart disease. Eur. Heart J. 2013; 18: 43–55.

20. Bohannon R. W., Maljanian R., Ferullo J. Mortality and readmission of the elderly one year after hospitalization for pneumonia. Aging Clin. Exp. Res. 2004; 16(1): 22–25.

21. Brazier J. E., Harper R., Jones N. M., O’Cathain A., Thomas K. J., Usherwood T., Westlake L. Validating the SF-36 health survey questionnaire: New outcome measure for primary care. BMJ. 1992; 305: 160–164.

22. Savage P. A., Shaw A. O., Miller M. S., Van Buren P., LeWinter M. M., Ades P. A., Toth M. J. Effect of resistance training on physical disability in chronic heart failure. Med. Sci. Sports Exer. 2011; 43: 1379–1386.

23. Богат С., Пономарева И., Горелик С. Саркопения в гериа- трической практике: диагностика, лечение, профилактика. Журнал врач. 2014; 6: 9–12 [Bogat S., Ponomareva I., Gorelik S. Sarkopenia in geriatric practice: diagnosis, treatment, prevention. Journal of the doctor. 2014; 6: 9–12] (In Russ).

24. Тареева И. Е. Практическое руководство. Нефрология. М.: Медицина; 2000: 688 [Tareeva I. E. Practical guidance. Nephrology. Moscow: Medicine; 2000: 688] (In Russ).