P2517Feasibility and safety of cardiac rehabilitation program during Ramadan fasting among patients having coronary artery disease and moderate left ventricular dysfunction

Abstract

Abstract Background Ramadan fasting (RF) is an important worship activity for Muslims. It entails complete abstinence of food and fluids from dawn to sunset (14–16 hours) for 30 days. The safety and feasibility cardiac rehabilitation program during (RF) is largely unknown. Aim To assess safety and feasibility of cardiac rehabilitation program (CRP) during (RF) in patients with coronary artery disease (CAD) with moderate left ventricular dysfunction (LVD). Moreover, to study the effect of (RF) on some blood parameters Patients and methods Fifty three patients joining (CRP) at our university hospital were included in the study. All had (CAD) with moderate (LVD). Patients were divided into two groups according to their Ramadan fasting status. Group I (fasting) were 32, while group II (non fasting) were 21. All patients underwent exercise training during cardiac rehabilitation in Ramadan. Serum lipid profile, plasma osmolality, renal functions, echocardiography and exercise parameters were assessed before and after (CRP).Clinical follow up was available for one month post Ramadan. Results The two groups were similar in baseline characteristics including: risk factors, serum osmolality, urea, creatinine, lipid profile, hemoglobin values, ejection fraction and exercise parameters.All patients successfully completed the (CRP). No patient in group I had any ischemic episode or exacerbation of (LVD) during or one month after the end of Ramadan.After the program, both groups showed significant improvement in ejection fraction (group I: 43±2% to 52±2%, p<0.001, group II: 41.1±4 to 47.2±3%. p<0.002), total cholesterol (group I: 174.8±40.8 to 169.4±37.1 mg%, p=0.034, group II: 172.9±43.3 to 163.0±40.7 mg%, p=0.01), LDL: Group I: 100.7±33.4 to 94.5±261 mg%, p=0.023, group II: 104.5±42.1 to 93.8±33.8 mg%, p=0.005), and HDL: Group I: 42.7±10.6 to 44.5±10.9 mg%, p=0.029, group II: 40.6±8 to 45±8.9 mg%, p<0.001). However, triglyceride levels improved significantly only in group I (162.3±65.4 to 152.8±52.3 mg%, p=0.042, group II: 144±60 to 133.9±48.8 mg%, p=0.149) l. There was also similar improvement in exercise duration after (CRP) in both groups. It is worthy to note that fasting did not increase the serum osmolality in group I (277.91±15.14 before, and 281.01±11.61 mmol/L after (RF), p value= 0.34) Conclusion Cardiac rehabilitation is feasible and safe among patients with (CAD) and (LVD) during (RF). Moreover, (RF) resulted in significant improvement in serum triglycerides without change in plasma osmolality denoting absence of hemoconcentration despite fasting.