AIM: To study action of medication in combination with free-choice bicycle exercise on cerebral and peripheral hemodynamics in patients with chronic heart failure (CHF) of functional class II to III. MATERIAL AND METHODS: At admission to hospital and at discharge 100 patients with CHF of NYHA functional class (FC) II to III hospitalized for progression of CHF have undergone clinical examination, Doppler echocardiography and biomicroscopy of conjunctival vessels. The patients were randomized into two groups: group 1 of 60 patients received standard drugs and exercised on bicycle: group 2 of 40 patients received standard drugs only. RESULTS: The patients of group 2 achieved better hemodynamic effect, greater lowering of total peripheral vascular resistance. In patients with CHF FC II cardiac output increased due to improvement of left ventricular systolic function (end-systolic and end-diastolic volumes reduced by 20.3 and 38.7%, respectively, ejection fraction increased by 13.7%); in patients with FC III -- due to improvement of diastolic function (end-diastolic volume reduced by 8.3%). Bicycle exercise in combined treatment of FC II CHF provides improvement in perivascular and intravascular components of microcirculation by 46.7 and 24.3%, respectively. In FC III CHF intravascular microcirculation improved by 24.3%. CONCLUSION: Bicycle exercise of patients with CHF of FC II and III used as an adjuvant to standard drugs has an additional positive effect on central hemodynamics and microcirculation.

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