# Harvard GTS step test when the progress of indicators and their interpretation

Harvard step test: it is based on the fact that the pulse rate after a standard load, fixed in the recovery period, will be the greater, the lower the physical fitness of the subject.

The test is a significant physical activity. So, by the end of its implementation (on the 5th minute of climbing a step), the average heart rate for athletes is 175 beats per minute, and oxygen consumption is 92 percent of the maximum. Therefore, the Harvard step test can be carried out only after a medical examination to exclude people with severe manifestations of heart disease, blood vessels and respiratory organs.

During testing, a person climbs a step whose height is selected according to age and gender, and descends from it at a pace of 30 times per minute for a predetermined time. When performing the test, the hands make the same movements as with ordinary walking. The test is more convenient to carry out under the metronome. One cycle of movements (ascent and descent) is performed on 4 accounts.

Immediately after the test, the subject sits down, and his heart rate is determined three times in 30-second segments: the first time after a minute in the recovery period (up to 1 min 30 s), the second time in the 3rd minute (from 2 min to 2 min 30 s ), the third – at the 4th minute (from 3 minutes to 3 minutes 30 s of the recovery period).

The athlete’s physical performance is judged by the index of the Harvard step test (IGST), which is calculated based on the time of climbing the step and heart rate after the test.

The greater the value of the Harvard step test index will be obtained, the therefore, the higher the level of physical fitness.

The Ruthier-Dickson test is a load complex designed to assess the performance of the heart during physical exertion.

There are direct and indirect, simple and complex methods for determining PWC. Among the simple and indirect methods for determining PWC are the Ruthier functional test and its modification, the Ruthier – Dickson test, which uses heart rate values ​​during recovery periods of various times after relatively light loads.

Ruthier Index = (4 * (Р1 Р2 Р3))/10 [1]

The results are evaluated by the index value from 0 to 15. Less than 3 – good performance; 3-6 – average; 7-9 – satisfactory; 10-14 – poor (average heart failure); 15 and above (severe heart failure)

There are other modifications to the calculation: ((P2-70) (P3-P1))/10

average – 5,1 – 10;

Harvard step test. This test was developed at the Harvard Laboratory for the Study of Fatigue under the direction of D. B. Dilla (1936). The test consists of climbing a bench 50,8 cm high with a frequency of 30 times in 1 min. If the subject gets tired and cannot maintain the set pace, the lifts stop and then the duration of work is fixed in seconds until the pace decreases. However, the duration of the exercise should not exceed 5 minutes.

three with one foot on the floor,

The height of the steps and the duration of the load depend on the gender, age and size of the body surface.

IGST = tx 100/(P1 P2 P3) x 2

where t is the ascent time (in sec); P1, P2 and P3 – pulse rate for 1, 2 and 3 minutes of recovery (counted in the first 30 from every minute).

IGST = tx 100/fx 5,5

where t is the ascent time in seconds, f is the heart rate (HR).

37 Determination of overall performance using the PWC150 and PWC170 samples. The methodology of bicycle ergometric option. The principle of determining the load for the first and second stage of the sample. Calculation and assessment of indicators. Methods of testing the physical performance of people with disabilities and people with health problems. Methodologies, evaluation criteria

1) increased heart rate during muscle work is directly proportional to its intensity (power or speed);

2) the degree of increased heart rate during unsaturated physical activity is inversely proportional to the functional capabilities of the cardiovascular system, which is an indirect criterion for overall physical performance.

The basis of the PWC170 test is the determination of the physical load power at which the heart rate reaches 170 bpm, i.e. the level of optimal functioning of the cardiorespiratory system.

It should be borne in mind that the maximum permissible height of the step is 50 cm, and the highest climbing frequency is 30 in 1 min. If necessary, an increase in load power can be achieved through artificial weights.

Evaluation of the data obtained is based on the relative values ​​of the PWCno indicator, which is calculated as the quotient of the division of the absolute values ​​(kgm/min or W/min) per kg of body weight (kg/min-kg or W/min kg)

Academy of the Federal Penitentiary Service of Russia, Ryazan

## Possible errors during the test

The Harvard test with a step platform is based on the fact that the level of physical fitness can be estimated by how long a person can tolerate a submaximal load. The second criterion is how quickly after it the heart rate indicator returns to normal.

When developing the test, an attempt was made to lay in a methodology for conducting physical activity in a strictly dosed form. But since the factor of the individual power of the movements performed is not taken into account, the measurements are considered conditionally dosed.

The advantages of this method include the simplicity and lack of need for special measuring instruments, as well as the ability to determine the level of physical performance, despite the fact that the subject may not stand the fixed test parameters.

During testing, a person can make mistakes, about the possibility of which they should be informed in advance. The most common of them:

• the set rhythm is not respected;
• knee joints while standing on a step are not fully extended;
• when on the platform, the body is not completely straightened;

A simple way to determine a person’s fitness was proposed back in 1942. For this, Harvard scientists used a bench (a prototype of a modern step platform). Its height is about 50 cm, and the pace of walking is 30 times per minute.

In a modified form, the step test is used to assess performance and develop training programs for athletes or those who want to continue training after a break. The advantages include the simplicity of conducting and calculating, the absence of expensive equipment.

The result may be affected by incorrect execution of the task. Therefore, all errors must be reported to the patient in advance, and check how he understands what is required of him during testing. The most common subjects’ mistakes are:

• lagging or ahead of the lifting rhythm,
• legs bent at the knees
• after lifting to the platform, the body is not straightened,
• the foot stands after the descent on the toe.

## Harvard step test

In 1942, a group of scientists at Harvard University developed a special test to determine the level of physical fitness of the US Army Marines. It consisted of climbing a bench 20 inches high (a little over 50 cm) at a certain pace (30 ascents per minute).

After a while, the test was finalized taking into account gender and began to be used to assess the physical performance of people involved in sports and physical education. Now this test is known as the Harvard Step Test.

The level of physical fitness of a person is assessed by the functional capabilities of the cardiovascular system, which are determined by the duration of the pulse from 170 to 200 beats per minute and the rate of recovery of the pulse after the load.

The creators of this step test attempted a strict dosing of physical activity. But you need to understand that the load power cannot be precisely determined, therefore dosing is considered conditional.

The Harvard step test index shows how quickly the processes in the body recover after intense short-term physical activity. The faster the pulse is restored after testing, the higher the index.

IGST is calculated in two ways.

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### 1 way

IGST = t * 100/(f1 f2 f3) * 2

where t is the time of the test (in this case, 5 minutes), f1, f2, f3 is the calculation of heart beats in the first 30 seconds of the second, third and fourth minutes of rest.

### 2 way

IGST = t * 100/f * 5,5

where t is the rise time, measured in seconds, f is heart rate (heart rate).

The Harvard Test Index is calculated using a special formula

The Harvard test was used to assess physical fitness and the level of adaptation to the workload of employees of the Gas Smoke Protection Service (GDZS) – the fire department that takes part in fighting fires in unsuitable respiration conditions.

To test the work of the GDZS employees, a metronome, a stopwatch, a step 50 cm high and 40 cm wide, and heart rate tomographs were used to measure the heart rate.

The step test for the employees of the gas and diesel service was carried out as follows:

• Humidity in the chamber is 25%, air temperature is 30 °.
• Everyday uniform.
• The frequency of rises – 30 times per minute.
• Those consists of four steps, each of which falls on one beat of the metronome.
• • Testing takes 5 minutes.

For more accurate studies of the level of physical preparation of gas smoke defenders, use step test No. 2, which is based on the PWC170 method developed at the Carolina University of Stockholm.

The principle of the test is based on the following nuances. Under normal conditions, when a person engages in normal daily activities, his heart contracts from 60 to 80 beats per minute. Moreover, all blood vessels of the body carry the volume of blood that is sufficient to supply oxygen to the organs and skeletal muscles.

In a well-trained, efficient person with a healthy heart, heart rate (pulse) increases, but after a certain time comes to normal values. As a rule, the recovery period is from several minutes to half an hour (depending on personal characteristics and training).

Based on this, as well as on knowledge and tables on the normal values ​​of heart rate, in 1942, doctors derived a formula for measuring the index, which allows to evaluate the fitness of the body. This test was invented at Harvard to assess the performance of young men called up for service in the Marine Corps.

Usually, a Harvard step test is used to assess athletes’ fitness. In particular, to assess the physical strength of persons involved in skiing, marathon walking, jogging, athletics.

In addition to professional athletes, a step test can be used to assess the performance of individuals who begin training in fitness centers or gyms. Also, with the help of a step test, contraindications from the heart are revealed if a person cannot bear the load used in the test.

!  ECG For pathologies, myocarditis, pericarditis, cardiomyopathy

For physically developed people who have been training in the gym for a long time, programs can be developed with the help of an instructor, depending on how much better the person has been able to tolerate physical activity.

Modification of the step test is used by employees of the gas smoke protection service (GDZS), as well as firefighters, in order to assess their physical endurance in extremely adverse conditions. But more often this contingent of people uses PWC170 – a test that allows you to evaluate the fitness of the heart and body, taking into account some quantitative indicators.

The name of this test came from the first letters of the term “physical working capacity” translated from English (physical working capacity), and the number 170 means the number of heartbeats that is optimal for the cardiorespiratory system to work under load, and this heart rate is achieved by a two-level load ( climbing on steps of different heights).

A Harvard step test should only be done for people with a healthy heart. Any diseases of the cardiovascular system are a strict contraindication for the study.

In addition to cardiological pathology, the subject during the study should not suffer from acute infectious diseases, diseases of the musculoskeletal system or experience general malaise and discomfort.

On the morning of the day of the study, the patient can have a light breakfast of low-fat and light foods, you should not overeat.

You should come to the procedure in comfortable clothes, not restricting movement, and in sports shoes.

The step test index (IGST) is calculated in order to determine how quickly an athlete recovers from physical activity, because this determines his endurance and the degree of load that he can endure without harm to health. In other words, a person’s endurance is determined by how quickly the heart rate decreases to normal values, and, therefore, how quickly the heart recovers after exercise.

The assessment of IGST is made according to one of two formulas. The latter is simplified and can be used in the case of mass research.

a) IGST = t x 100/(1 f2 f3) x 2

t is the time during which the step bench is climbed,

f1, f2, f3 – values ​​obtained by measuring the pulse, starting from the second minute of the recovery period.

t is the load time in seconds,

f is the pulse value.

Based on the result, you can assess the degree of fitness of a particular athlete. Despite the fact that different athletes have different levels of physical fitness, a test conducted at different times by the same person allows you to evaluate what the athlete’s achievements in training over a certain period of time.

For the test, you need a platform or step of calculated height (from 35 to 50 cm) depending on gender and age. Time – from 2 to 5 minutes. Since the pace of the test is very important for standardizing the result, it is recommended to use a metronome.

Before starting, you need to give the patient time to master the technique, then proceed with testing. The load consists in entering the step platform with one foot, and descending with the other. The free leg is attached to the working. Each step is performed on one beat of the metronome. He set the frequency of 120 beats per minute. The test passes, for example, like this:

1. With your right foot go up a step.
2. Put the left one.
3. Go down the left.
4. Put the right one.

During the test, you can change the working leg. Hands move arbitrarily, be sure to straighten completely after stepping. In 5 minutes, 150 such cycles are required. If the subject has lost his rhythm and cannot maintain the set pace, then conducting the test further is impractical. The time that the patient was able to pass is taken into account to calculate the result.

The Harvard step test (L. broucha, 1943) consists of climbing a bench 50 cm high for men and 43 cm for women for 5 minutes at a given pace. The rate of climb is constant and equals 30 cycles in 1 min. Each cycle consists of four steps. The tempo is set by a metronome of 120 beats per minute. After completing the test, the subject sits on a chair and for the first 30 seconds.

at the 2nd, 3rd and 4th minutes, heart rate is calculated. If the examinee lags behind the set pace during the testing process, the test is terminated. The athlete’s physical performance is judged by the index of the Harvard step test (IGST), which is calculated based on the time of climbing the step and heart rate after the test. The height of the step and the time of climbing it are selected depending on the gender and age of the subject (table. 23).

Table 23. Step Height and Climbing Time in the Harvard Step Test

Ascent time, min

Body surface 1,85 m 2

Girls and teens

Counting is easier when using the table. 24; 25; 26. Table 24 is provided for determining IGST in adults if the load has been sustained to the end (i.e. within 5 minutes).

Table 24. Table of finding the index for the Harvard step test in full form in adults (t = 5 min)

First, three pulse counts are summarized (f1 f2 f3 f4 = ∑f), then the first two digits of this sum are found in the left vertical column, and the last digit in the upper horizontal line. The desired IGST is located at the intersection of these lines. If the calculation of the pulse was made only once in an abbreviated form, then IGST are found by the value of this calculation in the same way in the table. 25.

## Testing as a diagnostic method

Analysis of the results of the level of physical endurance can be considered as a diagnosis and forecasting. In the case when the test person is not able to fulfill his age-related physical maximum, this indicates a deficiency of heart reserves, therefore, we can talk about the prospect of an undiagnosed coronary artery disease. Such violations are not able to determine electrocardiography and scintigraphic examination of the myocardium.

In a person with a healthy heart and a trained muscular system, the rhythm of heartbeats gradually increases to the maximum possible, and after a certain interval returns to the initial (normal) indicators. Recovery time depends on the individual level of physical fitness.

The advantages of the Harvard step test include its following features:

• It does not require the use of special equipment, as when conducting other tests with physical activity,
• Can be carried out when conducting large-scale research,
• It gives a fairly accurate estimate of the total endurance of a person, which is an important factor when starting sports training,
• Based on the previous paragraph, it allows the trainer or instructor to draw up an individual training program in the gym.

average – 5,1 – 10;

## An interesting Harvard step test for determining endurance: rules for conducting and probable errors

### 2 way

Endurance score is determined by the index. It reflects how soon the heart restores its normal rhythm after exertion. The shorter this time, the better the index, and hence the fitness. Calculation Method:

• 100 div >

In this case, one result is taken for the calculation, and instead of the coefficient “2” multiply the number by 5,5. The remaining stages remain unchanged.

The theoretical basis of the Harvard step test is a physiological pattern, according to which the duration of work at a pulse, equidom/min, and the speed of recovery of a pulse after performing such physical activity reliably characterizes the functional capabilities of the cardiovascular system and, as a result, the level of physical performance of the body.

Methodology: the subject is offered to perform muscle work in the form of ascents to the step with a frequency of 30 times per minute. The pace of movements is set by the metronome, the frequency of which is set to 120 beats/min. Ascent and descent consist of four movements, each of which corresponds to one metronome hit: on the count of times – the test subject puts one foot on the step, on the count of two – puts the other foot on the step, on the count of three – puts the foot on the floor with which to start climbing , on the count of four – puts the other leg on the floor.

In a standing position on a step, the legs should be straight, the body should be in a strictly vertical position. When raising and lowering the arms perform the usual walking movements. During the test, you can change the leg several times with which the ascent begins.

If the subject has strayed and is not able to maintain the set pace for 20 seconds, then the test is stopped and the time during which it was performed is recorded.

The duration of the load and the height of the steps depend on gender, age and anthropometric data (table 7).

Table 7 – Step Height and Climbing Time During Harvard Step Test

t– the duration of the physical work actually performed,

Appendices 3,4,5,6,7 provide tables for determining the index of the Harvard step test.

Evaluation of the results are shown in table 8.

Table 8 – Evaluation of the results of the Harvard step test

When comparing athletes in terms of IGST, some caution should be observed, since its absolute values ​​do not always correlate correctly with sports results. However, when re-examining the same athlete, the IGST reflects quite well the dynamics of the functional state of the cardiovascular system and physical performance.

The PWC170 test was developed by SjostrandT, WahlundH. at Carolina University of Stockholm in 1948 The testing procedure proposed by the Swedish scientists was very burdensome, since the athlete had to perform 5 or 6 loads increasing in power on a bicycle ergometer lasting 6 minutes each until reaching a heart rate of 170 beats. Therefore, the methodology developed by Karpman V.L. is more appropriate. et al. in1969

2) the degree of increased heart rate during unsaturated physical activity is inversely proportional to the functional capabilities of the cardiovascular system, which is an indirect criterion of physical performance.

Methodology: the subject performs two loads of increasing power on a bicycle ergometer (duration of each 5 minutes) with a rest interval of 3 minutes. Heart rate is recorded at the end of each load (last 30 seconds of operation at a certain power level) by palpation, auscultation, or electrocardiography. The latter method is more preferred.

– the sample should be carried out without preliminary warming up;

– the duration of each of the loads should be equal to 5 minutes, so that cardiac activity reaches a steady state;

– a 3-minute break is required between loads;

– at the end of the 1st load, heart rate should reach u/min, and at the end of the 2nd load – u/min (the difference is not less than 40 beats/min). The error in the calculation of the PWC170 can be minimized when approaching power during

The name of the step test is given in honor of Harvard University. It was his scientists in 1942 who developed this test. It is used to assess physical abilities before sports, especially running, to develop a training program, and also to evaluate the effectiveness of training.

How is the test conducted?

For the test, a step platform with a height of cm is taken (for women lower, for men higher) or a step suitable for height is selected.

And within 5 minutes, a basic step is performed from the right foot or the usual raising to the step and lowering from it. That is, it is necessary to perform four movements: put the right foot on the step – once, substitute the left foot for it – two, lower the right foot on the floor – three, lower the left foot behind it on the floor – four.

At the same time, you need to rise and fall at a certain pace: 30 rises and descents per minute. It turns out that in 5 minutes of the test you need to climb a step or step platform 150 times. As many times, respectively, and go down.

Then you should sit down or take any other convenient position and from the second minute count the pulse. The pulse is measured at the 2nd, 3rd and 4th minutes of rest for 30 seconds.

That is, starting from the second minute of recovery after a load, the number of beats per 30 seconds is measured, then a break is measured for 30 seconds and the pulse is measured again for 30 seconds, and then a break is taken, and again the pulse is considered 30 seconds. The result should be 3 values ​​indicating the number of heart contractions in 30 seconds.

Here, the values ​​f1, f2, f3 are the pulse measurement data for the 2nd, 3rd and 4th minutes of rest, and t is the test execution time (in this test the value is 5 minutes).

Experts warn that during the test, the load on the body is quite high. Therefore, they recommend taking the Harvard step test exclusively to people with good health or professional athletes.

IGST = tx100/(f1 f2 f3) x2

In fact, according to the Harvard test, it is estimated how quickly the body will recover after a short, but intense load. As a basis, indicators of the functioning of the cardiovascular system are taken. The body’s stamina depends on how quickly the cardiovascular system returns to its normal rhythm of work after an intense load.

• less than 55 – poor physical fitness;
• 55 – 64 – below the average level;
• 65 – 79 – average physical fitness;
• 80 – 89 – the level of physical fitness is good;
• 90 and more – excellent physical fitness.

Do not use too high a step (bench, chair). This will distort the test results.

Stand in front of the step and begin to step on it alternately with one foot or the other. Do it rhythmically with a frequency of about 30 steps per minute. That is, each step and return should take about 2 seconds.

The mechanics of movement are shown in the figure.

 Training level 18-25 years 26-35 years 36-45 years 46-55 years 56-65 years 65 Great Below 79 Below 81 Below 83 Below 87 Below 86 Below 88 Good 79 – 89 81 – 89 83 – 96 87 – 97 86 – 97 88 – 96 Above average 90 – 99 90 – 99 97 – 103 98 – 105 98 – 103 97 – 103 Average 100 – 105 100 – 107 104 – 112 106 – 116 104 – 112 104 – 113 Below the average 106 – 116 108 – 117 113 – 119 117 – 122 113 – 120 114 – 120 Weak 117 – 128 118 – 127 120 – 130 123 – 132 121 – 129 121 – 130 Very weak above 128 above 128 above 130 above 132 above 129 above 130

1. If you have an excellent or good level of training, your workouts may include a minimum of low-intensity cardio.

And this also means that the doors are open for you in strength training, circular training and in interval cardio training.

You can easily withstand these methods, and they will bring you a very tangible result, since the intensity of the classes can be quite high.

2. If your level of training is close to average, therefore, training should be supplemented with low-intensity cardio training to increase the stroke volume of the heart.

This means that three times a week you need to conduct at least half-hour training in the aerobic zone, which can be determined using this calculator: calculation of individual load zones.

A tangible result (recorded by the step test) from these classes will be noticeable after 2 or more months.

3. If your level of training is weak or very weak, you need to start daily walks at an ever-increasing distance.

And when the duration of walks per day reaches 1,5-2 hours, go for walks on hilly terrain or low-intensity running to increase the stroke volume of the heart.

## What the results show

The test results can be distorted by the incorrect behavior of the tested person, that is, his fuzzy implementation of the trainer’s instructions. Frequent violations include non-observance of the rhythm (speeding up or slowing down of steps relative to the metronome), stoop (the back should be in a clearly upright state), setting the foot not on the full foot, but on the toe, legs straightened in the knee joints.

To avoid mistakes, the person taking the step test should be instructed in detail before training. Harvard testing is a simple, affordable and informative way. By finding out the level of endurance, you can balance physical activity, while maintaining athletic performance while maintaining a healthy heart.

This step test is used to track a decrease or increase in fitness.

For athletes of a high level, IGST values ​​can reach up to 170. Similar results are typical for representatives of such types as skiing, a marathon, where a lot of time is devoted to endurance training.

When comparing athletes according to the IGST, it is necessary to take into account that the relationship between the index values ​​and sports results is not always true. But during repeated testing of the same athlete, the step test index quite reliably reflects the dynamics of the state of his cardiovascular system and the level of physical fitness.

The resulting figure is analyzed according to a special table. Its value is reflected in quality characteristics. For example, 55 units – this is a bad result, – the average. For athletes of a professional level, it can be about 170 units. Especially good results are among marathon runners and skiers.

Values ​​from 80 are considered good, and over 90 are considered excellent. It should be borne in mind that the Harvard Test will not always accurately reflect sports achievements, but when you repeat the test with the same athlete, you can reliably evaluate endurance.

Harvard Step Test Index

Using the Harvard step test, you can track the degree of increase in fitness or its decrease, for example, during breaks in training.

index less than 55 – poor physical fitness;

from 55 to 64 – preparedness below average;

from 65 to 79 – the average level of physical fitness;

from 80 to 89 – a good level;

from 90 and more – excellent physical fitness.

The Harvard step test index can reach up to 170. These results are shown by top-level athletes who devote a lot of time to endurance training, for example, ski racers or marathon runners.

## In conclusion

You should know that the load on the cardiovascular system during the Harvard step test is quite large. In the fifth minute, heart rate reaches 175 beats on average, about 3,5 liters of oxygen are consumed, pulmonary ventilation is about 75 liters per minute, and full recovery occurs after 20 minutes. Therefore, experts recommend this test only to professional athletes who have good physical training, and healthy people.

The test does not take into account the pulse before the load. This, in my opinion, is wrong.

## Preparation for the test

• a special platform or bench (step), half a meter high for men, and 10 cm lower – for women;
• sports stopwatch (can be replaced with a regular one on a watch or phone);
• rhythm fixation device (metronome).

Before starting the study, a person is given several minutes to get used to the bench, to master the technique.

### An exercise

The working frequency of the metronome is set to 120 beats per minute, under each of which a step is made on the bench, and descent from it. The step of the step test (platform) must be stable, and have an impressive weight, so that during the exercise it does not slip under the weight of the human body. The test is based on a simple four-step step aerobics basic step. In essence, this is the ascent to the platform/from the platform.

Step with one foot directly on the step bench, step with the supporting foot directly on the step platform (put your foot). The descent is carried out in the same order: a step with one foot from the step, a step with the second foot from the platform. A prerequisite is to put your feet on the full foot, straight back, and the limiting extension of the legs at the knees during training. For the upper extremities, special exercises are not expected.

Most often, people make reflex movements, as with ordinary walking. The multiplicity of ascents/descents is thirty per minute. The study time is 5 minutes. In other words, during testing, a person must complete 150 descents and ascents.

### Измерение

After a load time (5 minutes), the test person rests in a sitting position for 60 seconds. The rehabilitation period of the heart and respiratory system begins. Next, the heart rate is measured in the first half minute (30 seconds): in the second minute, in the third, and in the fourth. These three indicators are the basis for the Harvard Step Test Index (IGST), which will establish the level of human energy abilities, and the time interval required to restore the body.

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.