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   2019| October-December  | Volume 8 | Issue 4  
    Online since January 30, 2020

 
 
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ORIGINAL ARTICLES
Immediate effect of yogic postures on autonomic neural responses
Anup De, Samiran Mondal
October-December 2019, 8(4):106-113
DOI:10.4103/rcm.rcm_26_19  
Aim: The aim of this study is to identify the autonomic responses after immediate yogasana practices. Materials and Methods: Ten male (n = 10) yoga practitioners having more than 8 years of experience in yogasana practice were selected as subjects. Before and after immediate practices of six specific yoga postures were assessed on three different consecutive days for 15 min, 22.5 min, and 30 min. Heart rate variability (HRV) low frequency, HRV high frequency (HF), HRV amplitude, galvanic skin resistance (GSR), and blood volume pulse were assessed under the condition of autonomic neural activity and measured using NeXus-10 device. Results: Findings of the data generalized increasing of GSR (47.93% and 14.40%) and HF HRV (7.74% and 6.69%) and decreasing of low-frequency HRV (5.43% and 5%) immediately after 15 min and 22.5 min practice of yogasana, which indicates parasympathetic (vagal) activation. However, in the case of 30-min yoga practice, it decreased the GSR (11.03%) and HF HRV (2.59%), increased low-frequency HRV (2.23%) which, in turn, indicates the sympathetic activation. Discussion: The possible mechanism of vagal activation is an increase of baroreceptor sensitivity, tissue oxygenation, nervous system metabolism, and activation of vasodilation. It may be attributed to the activation of the head ganglion of the autonomic nervous system and inhibition of the posterior hypothalamic area. The sympathetic activation depends on the release of epinephrine and norepinephrine hormones, activation of vasomotor center, central neural integration, and peripheral inhibitory/excitatory reflex mechanisms. Conclusions: Immediate yogasana practices may enhance the parasympathetic (vagal) dominance, which increases autonomic flexibility and associates with a calm mental state.
  3,004 441 1
Study design: The effects of photobiomodulation therapy combined with exercise training on functional capacity and quality of life in patients with heart failure (double-blind randomized)
Homa Bahrami, Hassan Matin Homaei, Majid Maleki, Nasim Naderi
October-December 2019, 8(4):114-117
DOI:10.4103/rcm.rcm_27_19  
Background: Photobiomodulation therapy (PBMT), used to be called low-level laser therapy (LLLT), is a novel therapeutic method in which the red or near-infrared light is used to stimulate healing, relieve pain, and inflammation and prevent tissue from dying. Although in experimental investigations PBMT demonstrated to have many favorable effects on patients with cardiovascular disease, few clinical studies have been conducted in patients with heart failure (HF). Material and Methods: The present study is a single-center, randomized, double-blind, parallel-group controlled trial with placebo which will evaluate the effect of PBMT on functional capacity, quality of life (QOL), echocardiographic parameters, and serum biomarkers of patients with HF-reduced ejection fraction (HFREF) (left ventricular ejection fraction ≤ 40%) who will be referred to cardiac rehabilitation programs. The primary endpoint of the present study is to show the beneficial effect of PBMT on New York Heart Association functional class and the maximum distance walked during 6 min compared to control group. Our secondary endpoint is to show the effects of PBMT on serum pro-brain natriuretic peptide level and QOL. Conclusion: In the present clinical trial, for the 1st time, we will evaluate the effect of LLLT in patients with HFREF. The result of the present trial might introduce a new method for the rehabilitation of these patients.
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Predictors of complications among patients with acute inferior and right myocardial infarction
Khaled Emad El-Dein El-Rabat, Reda Biomy Bastwesy, Neama Ali ELMeligy, Shereen Ibrahim Farag, Nesreen Mohammed Zakaria
October-December 2019, 8(4):99-105
DOI:10.4103/rcm.rcm_21_19  
Introduction: Early recognition of acute right ventricular myocardial infarction (RVMI) is very crucial for the initiation of treatment to avoid complications. Objective: The objective of this study is to assess the predictors of complications in patients with acute inferior and RVMI. Patients and Methods: This prospective, single-center study included 100 patients with acute inferior and RVMI presented within 6 h of symptoms onset. All patients received streptokinase as thrombolytic therapy. The patients had undergone conventional two-dimensional echocardiography to assess LVEF, RVEF, RVFAC, and tricuspid annular plane systolic excursion (TAPSE), tissue Doppler to assess s', e', a' waves and myocardial performance index (MPI), and speckle tracking echocardiography to assess RV global longitudinal strain. All echocardiographic parameters were done within the first 12 h of admission and 2 months later. Results: Of 100 patients with acute RVMI; 27 patients had complications, the most common complication was atrioventricular block followed by cardiogenic shock. Mortality occurred in only one patient. On comparing the complicated and noncomplicated groups on admission, we revealed that; as regarding the clinical data, the female gender, presence of diabetes, lower systolic and diastolic blood pressure, and lower pulse were independent risk factors for occurrence of complications in RVMI with P < 0.029, 0.009, 0.004, 0.009, and 0.0001, respectively. Of the echo-cardiographic parameters on admission, dilated RV, lateral S, MPI, TAPSE, and speckle were independent predictors for the occurrence of complications in patients with RVI with P < 0.005, <0.0001, 0.0001, 0.0001, and 0.011, respectively. We can use lateral s', TAPSE, MPI, and speckle with cutoff value 7.9, 13.5, 0.765, −15.9, respectively, for prediction of in-hospital complications in acute RVMI patients (P < 0.0001 for each parameter). Conclusion: Of the echo-cardiographic parameters dilated RV, lateral S, MPI, TAPSE, and speckle were independent predictors for the occurrence of complications in patients with RVMI.
  1,002 132 -
Paraclinical cardiac findings of children with breath-holding Spells in Taleghani Hospital of Gorgan, Iran, during 2014–2016
Hassan Esmaeili, Seyyed Ahmad Hosseini, Maryam Montazeri, Zohre Rahatab
October-December 2019, 8(4):94-98
DOI:10.4103/rcm.rcm_12_19  
Context: Breath-holding spells (BHSs) are episodes of brief, involuntary cessation of breathing that occur in children in response to stimuli such as anger, frustration, fear, or injury. It occurs in about 0.1%–4.6% of healthy children. Although the etiology is not known, autonomic dysfunction and increased vagal tonus leading to cardiac arrest and cerebral anoxia are considered to play a role. Increase of QT dispersion increases the risk of sudden death. Because of this, children are always referred to cardiac clinics. Aims: Our aim was to evaluate According to these problems, our aim was the evaluation of ECG and Echocardiography findings in children diagnosed with BHSs in Taleghani Hospital in Gorgan. Settings and Design/ Methods and Material: All patients diagnosed with BHSs were enrolled in this study. In the first step, demographic characteristics and echocardiography and electrocardiogram (ECG) findings were obtained from the patients. Statistical Analysis Used: For statistical analysis, the demographic variables and ECG and echocardiography information of the patients were analyzed using frequency, percentage, and statistical tests such as Chi-square. Results: Sixty-three (9%) children were male and 36 (1%) children were female. Thirty-eight (9%) children were aged between 1 and 2 years, and this group was the most common age group. The most common type of attack was cyanotic (68/5%); 24 (1%) children had a positive family history, 78 (8%) had incomplete or absent iron supplementation, and 68% of children had anemia. Five (6%) children had long QT in ECG and five (6%) had abnormal echocardiography. There was a significant correlation between echocardiography findings and age, whereas there was no significant relationship between ECG findings with age, echocardiography findings with sex, and type of attack with age and sex. Conclusions: Although BHS among children with LQTS are relatively rare and occur at similar frequency as the general population, they can be the presenting symptom for a heart rhythm disorder.
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Correlation between Change in Blood Pressure and V02max in Indian Patients of Ischemic Heart Disease after Ischemic Reversal Program Therapy
Rohit Sane, Gurudatta Amin, Snehal Dongre, Rahul Mandole
October-December 2019, 8(4):89-93
DOI:10.4103/rcm.rcm_11_19  
Background: The control of blood pressure (BP) is crucial in improving the outcomes of ischemic heart disease (IHD) patients. Ischemia Reversal Program (IRP) has been proved to improve the aerobic capacity of IHD patients, but further validation is needed. Methodology: This retrospective study used the data of 78 patients who had visited Madhavbaug Clinics between July and December 2018. The mean VO2max, systolic BP (SBP), and diastolic BP (DBP) with heart rate (HR) after day 30 of IRP completion was compared with that on day 1 of IRP initiation. These values were evaluated separately after classifying the patients as those being normotensive and those having either elevated BP or hypertension (HTN). Pearson's test was used to correlate the change in SBP or DBP with VO2max. Results: Majority of the patients were male (n = 54) with the mean age of 59.94 ± 9.46 years. Majority of the IHD patients had elevated BP or HTN (n = 56). The mean HR decrease in both, the normotensive group and the group with elevated BP/hypertensive patients, was found to be statistically significant at the follow-up (P < 0.05). The mean SBP (119.48 ± 12.26 mmHg vs. 135.29 ± 15.59 mmHg) and the mean DBP (77.41 ± 9.06 mmHg vs. 91.18 ± 8.86 mmHg) were significantly decreased in the hypertensive group of patients at the follow-up (P < 0.05). For the normotensive patients, they were maintained in the normal range (P > 0.05). The negative correlations of SBP (R = −0.12, P > 0.05) and DBP (R = −0.32, P < 0.05) changes with VO2maxchange were found. Conclusion: IRP increased the VO2maxand reduced the BP in IHD patients with elevated BP. The reduction in BP correlated with an increase in VO2maxin IHD patients.
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