Журнал кардиореспираторных исследований 2026. №3

Тема статьи

Clinical and instrumental features of coronary heart disease in patients with coronary artery anomalies and the effectiveness of comprehensive cardiac rehabilitation (102-107)

Авторы

Xasanjanova F.O., Rizayev J.A., Tashkenbayeva E.N.

Учреждение

Samarkand State Medical University

Аннотация

Introduction: Coronary artery anomalies represent a heterogeneous group of congenital changes in their origin, course, and anatomy, which in some cases may contribute to the development of myocardial ischemia. The clinical significance of such anomalies increases significantly when combined with atherosclerotic lesions of the coronary artery bed and coronary heart disease (CHD). Diagnostic difficulties are due to the variability of the clinical picture, the possibility of an asymptomatic course, and the need to simultaneously evaluate the anatomical and functional characteristics of coronary blood flow. Following revascularization, comprehensive cardiac rehabilitation is of particular importance, aimed at restoring physical performance, improving quality of life, and reducing cardiovascular risk. Purpose of the study. To evaluate the clinical and instrumental characteristics of coronary artery disease in patients with coronary artery anomalies and determine the effectiveness of a comprehensive cardiac rehabilitation program after revascularization. Materials and methods. The model study included 120 patients with coronary artery disease aged 38-69 years, who exhibited coronary artery abnormalities based on coronary computed tomography and/or invasive coronary angiography data. The average age was 54.8±8.7 years. All patients underwent clinical examination, electrocardiography, echocardiography, laboratory diagnostics, assessment of physical load tolerance, and quality of life. 86 patients underwent percutaneous coronary intervention (PCI), 14 underwent surgical revascularization, and 20 patients received optimal drug therapy. After condition stabilization, patients in the primary group underwent a 12-week comprehensive cardiac rehabilitation program. Results. The most frequently identified were abnormal departures of the right coronary artery from the opposite sinus of Valsalva (34.2%), the myocardial bridge (25.0%), and the abnormal position/path of the anterior interventricular branch (15.0%). In 70.8% of patients, hemodynamically significant atherosclerotic lesions of the coronary arteries were noted. After 12 weeks of rehabilitation, the six-minute walking distance significantly increased from 418±76 to 486±69 m (p<0.001), the frequency of angina attacks decreased from 3.2±1.4 to 1.1±0.8 per week (p<0.001), and the left ventricular ejection fraction improved from 51.8±6.2 to 55.1±5.8% (p<0.001). An increase in quality of life indicators and adherence to drug therapy was noted. Conclusion. The association of coronary artery anomalies and coronary heart disease is characterized by a complex clinical-anatomical phenotype and requires a comprehensive assessment of coronary artery anatomy and the functional significance of the identified changes. The introduction of individualized cardiac rehabilitation after revascularization is associated with improved physical work capacity, a reduction in angina severity, and an improvement in quality of life.

Ключевые слова

coronary artery anomalies, coronary heart disease, coronary angiography, computed tomography, TOKA, revascularization, cardiac rehabilitation, physical work capacity, quality of life

Литературы

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