Successes achieved in the treatment of patients with coronary heart disease (CHD) after acute coronary syndrome and cardiosurgical interventions require the development of new, more advanced methods for their rehabilitation. This is because of metabolic disturbances persistence in the deeply ischemic myocardium in patients with coronary heart disease even after restoration of blood flow through the coronary arteries by surgical or endovascular methods due to the development of the phenomenon of stunning and hibernation. The discovery of the development of their own adaptation to ischemia phenomenon opens up new possibilities in the correction of the metabolism of the ischemic myocardium, which significantly increases the efficiency of patient postoperative rehabilitation. PURPOSE OF THE STUDY: The scientific rationale for improved cardiac rehabilitation programs for patients after acute coronary syndrome and cardiac surgery. MATERIAL AND METHODS: 120 patients who were randomized to 3 groups (40 patients each) were examined: the main and two control, comparable in the major clinical manifestations of the disease. Improved methods of physical training with the inclusion of interval cyclic training for the first time in cardiology on treadmills and sensory tracks and therapeutic exercises in the gym (daily, 5 times a week, for a course of 10 procedures) were performed for patients of the 1st control group. Therapeutic procedures that improve metabolic processes in the ischemic myocardium were used in patients of the 2nd control group: enhanced external counterpulsation, general dry air carbon dioxide, infrared matrix laser therapy. Rehabilitation by the complex of the above physical training and factors which restored metabolic processes in the ischemic myocardium was carried out to patients of the main group. Methods had a cardioprotective effect and increase myocardial adaptation to ischemia. RESULTS: The greatest anti-ischemic, antianginal, antihypoxic effects were achieved in patients of the main group compared with the control groups. What may be due to the correction of metabolic disorders and the development of cardioprotection of ischemic myocardium. The consequence is a significant increase in the rehabilitation effect of improved cardiovascular training. CONCLUSION: The achieved result is due to the integration of improved cardiac training techniques and a procedure package aimed at cardioprotection and metabolic myocardium adaptation to ischemia, which included enhanced external counterpulsation, general dry air carbon dioxide and infrared matrix laser therapy.

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