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Role of Integrated approach of pharmacological plus non pharmacological therapy in severe chronic heart failure patients.

Session Poster Session 1

Speaker Naresh Sen

Event : Heart Failure 2018

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Clinical, Other
  • Session type : Poster Session

Authors : N Sen (Jaipur,IN), SONAL Tanwar (Jaipur,IN), ASHOK Jain (Jaipur,IN)

Authors:
N Sen1 , SONAL Tanwar2 , ASHOK Jain1 , 1Narayana Hrudayalaya, Cardiology - Jaipur - India , 2HG SMS Hospital, Cardiology - Jaipur - India ,

Citation:

Background: Studies revealed non pharmacological therapy consisting of yoga, meditation ,exercise and education training, in combination with diet counselling ,stress management , Enhanced external counter pulsation machine (EECP) have good role to prevent worsening heart failure

Aim: Integrative program with focus on Integrated Medicine with life style intervention in patients with severe chronic heart failure and beneficial outcome of integrated approach. 

Methods: The Observational study a 3-year outpatient : A total of 202 middle-aged men and women, chronic heart failure with Hypertension, dyslipidemia, type 2 Diabetes mellitus and obesity were enrolled. The usual care (routine allopath medicines) group A(n=106)  and the integrated approach( allopathy plus non pharmacological ) with life style interventional group B (n=96).  For Group B- Education, Exercise: supervised endurance and yoga , meditation with restricted diet and aerobics: three times a week for three months with Enhanced external counter pulsation machine (EECP) four cycle weekly for 5 months . 

Results: Proposed lifestyle improved after year 3 in the  group A over group B. There were significant differences between groups, mean changes (and  their 95% confidence intervals, CI) in waist circumference  pv0.001),  in waist–hip ratio  p<0.01) , decrease in HR (p<0.01), systolic BP (p<0.01) and diastolic BP(p<0.05) blood cholesterol and sugar, HBA1C level . Recurrent hospitalization with congestive heart failure (CHF) in group A =23/106, group B =7/96( p<0.03) . Atrial fibrillation in group A =12/106, group B =3/96 (p<0.08).Ventricular tachycardia in group A =8/106, group B =3/96( p<0.23). Death in group A =18/106, group B =6/96( p<0.36).Post MI-CHF in group A =9/106, group B =3/96( p< 0.36). Post CABG-CHF in group A= 8/106, group B=2/96. 

Conclusion: Regular 3-year follow-up improvements in quality of life, decrease stress, decrease incidence of cardio-vascular events , improve Exercise Score, better reduction of heart rate, blood pressure, weight, waist circumference, three to four time decrease episodes  of recurrent hospitalization , Cardiac Arrhythmias and 33% reduction of cardiovascular mortality in integrated group as compare to usual group.

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