CLINICAL EFFICACY OF TRAINING AND ACTIVE OUTPATIENT MANAGEMENT OF PATIENTS WITH CHRONIC HEART FAILURE

Aim: To study the effect of training and active outpatient management of patients with CHF on patient adherence to therapy, hemodynamic and echocardiographic parameters, clinical status and tolerance to physical activity. Material and methods: The study included 204 patients with CHF, aged 19 to 82 years, admitted in the Center of Cardiology. Structured classes for CHF were conducted with patients during their stay in the hospital, and active telephone contacts were also conducted after the discharge of patients. During the followup period (12 months), the dynamics of the following parameters was analyzed: the clinical status of patients, the distance of the 6-minute walk test, the objective parameters of the structure and function of the heart according to echocardiography, patient adherence to treatment. Results: The main cause of CHF was CAD (58.8 %), more than half of cases it was combined with arterial hypertension. Training and dynamic monitoring of patients compliance with the doctor’s recommendations allowed to really maintaining a sufficiently high adherence of patients to therapy. In all methods of objectifying clinical status (dynamics of hemodynamic and echocardiographic parameters, clinical assessment scale and distance of 6-min walk), statistically significant positive dynamics was obtained and significant differences were noted by the 6th month. All this testifies to the positive impact of training, active outpatient management and adequate therapy on the basic parameters of the cardiovascular system of our patients. Key words: chronic heart failure, training, active outpatient management, adherence to therapy, indicators of echocardiography, 6-minute walk test, clinical condition.