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Left-ventricular (LV) systolic-diastolic function and cardiac rhythm variability, the rate of pathological LV remodeling and outcomes of the disease for 18 months were studied in 394 males at the age 35-68 years suffering from chronic cardiac failure (CCF) of NYHA functional class I-II consequent to myocardial infarction occurring 9.6-4.2 months before. It was found that long-term (12-24 weeks) taking sauna, underwater dousch-massage, general effervescent baths and exercise in combination with drug therapy in patients with asymptomatic CCF inhibit the rate of LV remodeling, decrease LV hypertrophy, improve diastolic function of the heart. This results in lowering a cumulative risk of unfavourable outcomes of the disease by 42% (p = 0.006). The best of effect of the combined therapy is not achieved in angina of effort, massive myocardial hypoperfusion zones, no viable myocardium in the zones of the lesion, marked LV hypertrophy.

Myocardial infarction survivors took general carbon dioxide baths and/or did therapeutic exercises. Compared to controls, all these patients experienced a significantly less number and duration of episodes of ST-segment ischemic depressions detected at 24-h ECG monitoring while significant differences by cardiac rhythm variability before and after the treatment were not registered though the test group showed the trend to normalization of the heart rhythm.

78 patients with postmyocardial infarction cardiosclerosis and moderate chronic cardiac failure (NYHA functional class 0-2) were given standard medication (enalapril, aspirin, atenolol) and took underwater massage douche. The effects of the latter on diastolic dysfunction of the left ventricular myocardium were studied. The above hydrotherapy changed parameters of left ventricular diastolic filling in 64% of the examinees: in 40% these parameters improved, in 23%--deteriorated. Clinical and device criteria essential for hydrotherapy outcomes are described.

The trial included 63 postmyocardial infarction (PMI) men aged 40-65 years with cardiac failure (CF) NYHA functional class I-II and/or left ventricular (LV) diastolic dysfunction. The patients were randomized into two groups: the study group and the controls. The former received medication plus carbon dioxide baths, the latter received medication only. As shown by two-dimensional echocardiography there were no significant differences between the groups by LV function, volume, myocardial mass. In patients of the study group, ejection fraction increased in 75% patients, in controls--in 62%. In those who have taken baths ejection fraction increased if it was low before the treatment. Transmitral blood flow measured with spectral dopplerography indicated significant changes in diastolic function in the study group. Thus, balneotherapy with carbon dioxide baths significantly improves LV diastolic function and myocardial contractility in patients with impaired LV systolic function.

Immediate and long-term responses to pelotherapy were evaluated in 80 patients with ischemic heart disease (IHD) combined with osteochondrosis. The effect was registered in 75-82% of the IHD patients with painless disease or angina pectoris functional class II and III. The clinical improvement was confirmed by 24-hour ECG monitoring findings and bicycle ergometry results. The effect persisted for 12 months in the majority of patients with IHD functional class II and with painless IHD, but only in 15% of those with IHD functional class III. Contraindications to peloids are specified.

Exercise test in coronary patients with angina of effort class II and III, painless cardiac ischemia reflected their increased coronary and myocardial reserves due to peloid therapy of cervical and thoracic osteochondrosis. As indicated by bicycle ergometry, angina of effort class III complicated by attacks of retrosternal pain at rest, circulatory insufficiency stage IIA, complex arrhythmia present contraindications for peloid application.