Abstract
Heart failure is considered as a life-threatening epidemic disorder affecting about 26 million world's population and associated with considerable morbidity, mortality and healthcare expenses. Despite the availability of a range of advanced treatments and sophisticated therapies the prevalence of heart failure represents a herculean challenge. To address the challenge, the current investigation was conducted by evaluating the efficacy of Heart Failure Reversal Therapy (HFRT) in reducing left ventricular distress by assessing N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in congestive heart failure (CHF) patients. Total 76 CHF patients with NYHA Class II and III were screened from March to May 2017 and 15 CHF patients with NT-proBNP = 300-1500 pg/ml were selected for the study. NT-proBNP is measured as a marker, the value of which increases with an increase in severity of CHF. The study therapy, HFRT comprises of traditional procedure of panchkarma that includes snehana (external oleation), swedana (passive heat therapy), hrudaydhara (concoction dripping treatment) and basti (medicated enema) was administered twice daily for 7 days. Post-HFRT, ARJ kadha was administered for next 12 weeks follow-up. NT-proBNP levels were measured after a follow-up period of 90 days along with some other parameters like BMI, VO 2peak (evaluated by cardiac stress test with modified Bruce protocol) and weight. The findings of the investigation revealed significant reduction in NT-proBNP levels (42.46%, p = 0.009), weight (4.82%, p = 0.0007) and BMI (3.67%, p = 0.034) at the end of the follow-up period. The study also yielded significant improvements in VO 2peak (50.96%, p = 0.004). The overall results suggest that HFRT can possibly be explored as add-on therapy or a feasible alternative for the effective management of CHF.
Highlights
Chronic Heart Failure (CHF) is a prevalent systemic disease affecting a significant proportion of the population worldwide. [1] Recently published INTER-CHF prospective cohort study reported India has 23% annual mortality rate owing to CHF alone. [2] Pioneering research studies have led to a change in the classic approach and development of new therapies which have ameliorated symptoms and improved the survival rate of patients with CHF
Patients willing to participate in the study and belonging to New York Heart Association (NYHA) Class II and III with NT-proBNP levels = 300-1500 pg/ml were included in the study
There was a 42.46% reduction in NT-proBNP levels which is statistically significant (p = 0.009)
Summary
Chronic Heart Failure (CHF) is a prevalent systemic disease affecting a significant proportion of the population worldwide. [1] Recently published INTER-CHF prospective cohort study reported India has 23% annual mortality rate owing to CHF alone. [2] Pioneering research studies have led to a change in the classic approach and development of new therapies which have ameliorated symptoms and improved the survival rate of patients with CHF. [2] Pioneering research studies have led to a change in the classic approach and development of new therapies which have ameliorated symptoms and improved the survival rate of patients with CHF. This chronic condition continues to remain a progressive disease causing incremental morbidity and early mortality. Along with development in the treatment of CHF, it is important to have good diagnostic markers. Good diagnostic markers help in analysis of efficacy of treatment and/or disease progression etc. Measurement of circulating levels of brain natriuretic peptide (BNP), a biologically active peptide of 32 amino acids with natriuretic properties, has become a potential diagnostic aid to identify patients with heart failure. [5, 6]
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