To develop a new approach to cardiac rehabilitation for patients with different cardiovascular diseases based on novel theoretical principles in pathophysiology of decreasing and recovery of physical capacity in cardiovascular continuum.

We studied pathophysiological mechanisms of tolerance to physical loading and aerobic physical capacity reducing at 529 patients in different stages cardiovascular continuum: 74 pts with metabolic syndrome (MS), 113 pts with arterial hypertension, 229 pts with myocardial infarction (MI) and 32 pts with terminal stage of heart failure (HF) needed for heart transplantation. We used 24h Holter monitoring, blood pressure daily monitoring, echocardiography, spiro bicycle ergometry test (spiroBET), treadmill test, 6-minute walk test, and blood biochemistry were performed according to standard ways.

Developed programs of cardiac rehabilitation were different at pts with MS, hypertension, MI and HF and depended on functional reserve revealed by spiroBET, treadmill test and 6-minute walk test. Under the influence of new approach to physical rehabilitation, a better tolerance to physical exercise and aerobic physical capacity has been observed. Improving in functional status of blood circulatory system reached due to development of mechanisms of short-term and long-term adaptation, switch of cardiovascular system to a more saving functioning mode, and less severe respiratory and metabolic disorders. We also established that developed approach to physical rehabilitation leaded to improving not only medical but also social and economic efficiency.

Cardiovascular rehabilitation should be continual and unbroken process starting from patient with risk factors (MS and hypertension) and not been interrupted at ending stages of cardiovascular continuum.