Effectiveness of Heart Failure Reversal Therapy in Chronic Heart Failure Patient with the Progressive Evaluation of NT-pro BNP: A Case Report
Published: 2022-12-14
Page: 349-358
Issue: 2022 - Volume 5 [Issue 1]
Shalaka Gaikwad-Patil *
Vijapur Road Solapur Madhavbaug Clinic, Maharashtra, India.
Ranjit Narang
Madhavbaug Cardiac Clinic and Hospital, Thane, Maharashtra, India.
Rahul Mandole
Department of Research & Development, Madhavbaug Cardiac Clinic and Hospital, Thane, Maharashtra, India.
*Author to whom correspondence should be addressed.
Abstract
There is a need to search for an alternative form of therapy that will not only limit the disease but also overcome hindrances encountered with conventional medications used for the treatment of heart failure. There is a paucity of evidence on the effect of Heart failure reversal therapy (HFRT) on N-terminal pro-B-natriuretic peptide (NT-pro BNP) levels in patients of chronic heart failure, hence we report 3 cases of chronic heart failure who were treated with HFRT. All the 3 cases had symptoms like dyspnea on exertion (grade 4), chest pain referred to the left arm, palpitations, and giddiness. Their echocardiography revealed reduced left ventricular ejection fraction and left ventricular dysfunction. Amongst the investigations, the most noteworthy finding was raised NT-pro BNP which was 909, 608, and 956 pg/ml. Patients were given a diet kit consisting of fewer calories (1000 calories), low carbohydrate, moderate protein and fat, and high antioxidant capacity. HFRT was given to the patient in the form of Snehana (~therapeutic oleation), Swedana (~sudation therapy), Basti (~therapeutic enema) and hrudaydhara (~thoracic drip therapy) was administered to the patient twice in a week for 12 weeks. Post-therapy there was a uniform improvement in vital parameters, echocardiography, and NT-pro BNP values. The present case study highlighted the synergistic effect of HFRT and portion and calorie control diet in improving not only clinical but also prognostic parameters of the disease.
Keywords: Heart failure, prognostic parameters, NT-pro BNP, panchakarma, heart failure reversal therapy
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References
National clinical guideline centre. Chronic heart failure: Management of chronic heart failure in adults in primary and secondary care. Nice clinical guideline 108. National Institute for Health and Clinical Excellence, Manchester; 2010.
Available:http://www.nice.org.uk/nicemedia/live/13099/50517/50517.pdf
McKelvie RS, Moe GW, Ezekowitz JA, Heckman GA, Costigan J, Ducharme A et al. The 2012 Canadian Cardiovascular Society heart failure management guidelines update: Focus on acute and chronic heart failure. Can J Cardiol. 2013;29:168-181.
McMurray JJV, Adamopoulos C, Anker S, Auricchio A. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur. Heart J. 2012; 33:1787-1847.
Sane R, Mandole R, Furia H, Dhamne R, Gharat Y, Joshi S, et al. Efficacy of Heart Failure Reversal Therapy (HFRT) Program in Patients with Preserve Ejection Fraction: An Observational Study. Ayurpub. 2018; 3(5):1048-105.
Kemps HM, De Vries WR, Hoogeveen AR, Zonderland ML, Thijssen EJ, Schep G. Reproducibility of onset and recovery oxygen uptake kinetics in moderately impaired patients with chronic heart failure. Eur. J Appl. Physiol. 2007; 100(1):45-52.
Piepoli MF, Davos C, Francis DP, Coats AJ. ExTraMATCH Collaborative. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTra-MATCH). BMJ. 2004;328(7433):189.
Keteyian SJ, Brawner CA, Savage PD. Peak aerobic capacity predicts prognosis in patients with coronary heart disease. Am Heart J. 2008;156(2):292-300.
Rowell LB, Detry JR, Profant GR, Wyss C. Splanchnic vasoconstriction in hyperthermic man: Role of falling blood pressure. J Appl. Physiol. 1971;31: 864-9.
Hulsmans M, Sager H, Roh J, Valero-Muñoz M, Houstis N, Iwamoto Y. Cardiac macrophages promote diastolic dysfunction. The Journal of Experimental Medicine. 2018;215(2):423-40.
Thatte U, Kulkarni A, Ghungralkar R, Panchal F, Vetale S, Teli P. Immunological and metabolic responses to a therapeutic course of Basti in obesity. Indian Journal of Medical Research. 2015;142 (1):53-62.
Vardeny O, Claggett B, Packer M. Efficacy of sacubitril / valsartan vs. enalapril at lower than target doses in heart failure with reduced ejection fraction : The PARADIGM-HF trial with ACEI to Determine Impact on Global Mortality and Morbidity in Heart. Eur J Heart Fail. 2016;1-7.
Januzzi JL, Van Kimmenade R, Lainchbury J. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: An international pooled analysis of 1256 patients: The international collaborative of NT-proBNP study. Eur. Heart J. 2006; 27:330-337.