DAILY PROFILE DYNAMICS OF BLOOD PRESSURE AND DIASTOLIC FUNCTION OF LEFT VENTRICLE IN CARDIAC REHABILITATION PATIENTS DEPENDING ON SMOKING FACTOR.

Aim of the research - to study the peculiar features of the left ventricle (LV) diastolic function (DF) and regulation of arterial pressure (AP) in patients with a history of acute coronary syndrome (ACS) in cardiac rehabilitation treatment dynamics depending on smoking factor. 114 patients at the age of 42-78 years old (average age 56,61±1,35) that have recently had ACS (less than 28 days ago) have been examined and have passed cardiac rehabilitation programme in the rehabilitation department after cardiac diseases at "Morshynkurort" sanatorium-resort complex. All patients have been divided into 2 groups according to smoking habit. Patients with smoking factor (smokers, n=64, average age 54,94±1,6 years old) belonged to the 1st group, patients without smoking factor (non-smokers, n=50, average age, 58,64±1,4 years old) belonged to the 2nd group. The 1st groupwas divided into 2 subgroups in the end of resort rehabilitation in order to evaluate dynamic of researched indices: IA - smokers (n=36), that gave upsmoking during the process of cardiac rehabilitation (CR), and IB - smokers (n=28) that continued smoking. Main indices of daily arterial blood pressure monitoring (DBPM) and LV DF were detected in patients of the research groups during the 1st and 24th days of rehabilitation treatment. In the beginning of cardiac rehabilitation programme higher mean-diurnal values of systolic arterial pressure (SAP) and diastolic arterial pressure (DAP), post-take increase SAPand DAP, morning SAPand DAP, day and night SAPand DAPvariability, also average indices of LV DF and in particular DT, IVRT and E/A correlation were detected in patients of the 1st smoking group(I) in comparison with the 2nd non-smoking group(II). Dynamics analysis of APregulation indices detected that the better positive dynamics together with achievement of the target, recommended levels of DBPM indices were being registered in the groupof non-smokers (II) and in the groupof smokers that quit smoking (IA), compared to the groupof patients - persistent smokers (IB). Positive changes also weren't detected at the end of rehabilitation treatment by dynamics of indicators of (DT, IVRT, correlation E/A and E/e'). At the same time significant positive dynamics was observed in patients that got out of the habit of smoking (IA). Smoking factor in patients with earlier ACS is associated with more significant disorders of regulation of APand LV DF. Smoking cessation must be obligatory, controlled part of cardiorehabilitation program for patients that had ACS. Therefore, rapid (during 24 days) appreciable improvement of diurnal profile of APand LV DF is smoking cessation consequence. Significant reduction and target values achievement of APvariability, APmorning levels, even against the background of proper physical training, were not observed in patients - persistent smokers.