[The vegetative status of patients after myocardial infarction, and the effectiveness of sanatorium rehabilitation].

The aim of the study was to investigate the dynamics of functional variables and the vegetative status of patients undergoing sanatorium rehabilitation with different results. The subjects, 106 patients aged 48.6 +/- 0.95, who had had myocardial infarction, were divided into 3 groups according to the dynamics of physical exercise tolerance (PET) in the course of treatment: group I, 39 patients with a significant (more than 10W) increase in PET; group II, 47 patients with no change in PET or with a small (up to 10W) increase in PET; group 3, 20 patients with a decrease in PET. An initial examination showed PET was the lowest in group 1. Group 3 patients displayed the lowest ejection fraction, the biggest end-diastolic volume and left ventricular (LV) asynergy at an initial examination, as well as higher incidence of ventricular premature beats; this group contained more patients with large-focal MI, LV aneurism, and postinfarction stenocardia. After treatment group 1 patients demonstrated an increase in the low-frequency component of the spectral parameters of cardiac rhythm variability (CRV) according to ECG at rest; active orthostatic test (AOT) revealed a moderate increase in the variables of sympathovagal balance, which could be considered to demonstrate the recovery of the impaired sympathetic reactivity. Group III patients demonstrated a decrease in the low-frequency component of the CRV spectral parameters at rest after treatment; AOT demonstrated a shift from an initial inadequate sympathetic reactivity to hyperreactivity, which might reflect a "stale" condition in these patients. The data of the study will help to plan individual physical rehabilitation programs and to control exercise tolerance in cardiological patients.