To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure

Sane Rohit; Mandole Rahul

doi:doi:10.11648/j.ccr.20180203.13

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To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure

Sane Rohit, Mandole Rahul

Published in Cardiology and Cardiovascular Research (Volume 2, Issue 3)

Received: 19 August 2018 Accepted: 10 October 2018 Published: 30 October 2018

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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.

Published in	Cardiology and Cardiovascular Research (Volume 2, Issue 3)
DOI	10.11648/j.ccr.20180203.13
Page(s)	61-64
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

NT-proBNP, Chronic Heart Failure, Heart Failure Reversal Therapy

References

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[2]	Dokainish H, Teo K, Zhu J, et al (2017) Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study. Lancet Glob Heal 5:e665–e672. doi: 10.1016/S2214-109X(17)30196-1.
[3]	Ramani G V., Uber PA, Mehra MR (2010) Chronic heart failure: Contemporary diagnosis and management. Mayo Clin Proc 85:180–195. doi: 10.4065/mcp.2009.0494.
[4]	Sane R, Aklujkar A, Patil A, Mandole R (2017) Effect of heart failure reversal treatment as add-on therapy in patients with chronic heart failure: A randomized, open-label study. Indian Heart J 69:299–304. doi: 10.1016/j.ihj.2016.10.012.
[5]	Troughton RW, Frampton CM, Yandle TG, et al (2000) Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations. Lancet 355:1126–1130. doi: 10.1016/S0140-6736(00)02060-2.
[6]	Redfield MM (2004) Plasma Brain Natriuretic Peptide to Detect Preclinical Ventricular Systolic or Diastolic Dysfunction: A Community-Based Study. Circulation 109:3176–3181. doi: 10.1161/01.CIR.0000130845.38133.8F.
[7]	Vanderheyden M, Bartunek J, Goethals M (2004) Brain and other natriuretic peptides: Molecular aspects. Eur J Heart Fail 6:261–268. doi: 10.1016/j.ejheart.2004.01.004.
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[9]	Coelho-Ravagnani C de F, Lemos Melo FC, Ravagnani FCP, et al (2013) Estimation of the metabolic equivalent (MET) of an exercise protocol based on indirect calorimetry. Rev Bras Med do Esporte 19:134–138. doi: 10.1590/S1517-86922013000200013.
[10]	Yamamoto K, Burnett JC, Jougasaki M, et al (1996) Superiority of Brain Natriuretic Peptide as a Hormonal Marker of Ventricular Systolic and Diastolic Dysfunction and Ventricular Hypertrophy. Hypertension 28:988 LP-994.
[11]	Omland T, Aakvaag A, Bonarjee VVS, et al (1996) Plasma Brain Natriuretic Peptide as an Indicator of Left Ventricular Systolic Function and Long-term Survival After Acute Myocardial Infarction. Circulation 93:1963 LP-1969.
[12]	Davidson NC, Naas AA, Hanson JK, et al (1996) Comparison of atrial natriuretic peptide B-type natriuretic peptide, and N-terminal proatrial natriuretic peptide as indicators of left ventricular systolic dysfunction. Am J Cardiol 77:828–831. doi: 10.1016/s0002-9149(97)89176-x.
[13]	McDonagh TA, Robb SD, Murdoch DR, et al (1998) Biochemical detection of left-ventricular systolic dysfunction. Lancet 351:9–13. doi: 10.1016/S0140-6736(97)03034-1.
[14]	Jolobe O (1995) Detection of left ventricular dysfunction after myocardial infarction: comparison of clinical, echocardiographic, and neurohormonal methods. Br Heart J 73:101–102.
[15]	Bay M, Kirk V, Parner J, et al (2003) NT-proBNP: a new diagnostic screening tool to differentiate between patients with normal and reduced left ventricular systolic function. Heart 89:150–4. doi: 10.1136/heart.89.2.150.
[16]	Vardeny O, Claggett B, Packer M, et al (2016) 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 1–7.
[17]	Januzzi JL, Van Kimmenade R, Lainchbury J, et al (2006) 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 27:330–337. doi: 10.1093/eurheartj/ehi631.

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APA Style

Sane Rohit, Mandole Rahul. (2018). To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure. Cardiology and Cardiovascular Research, 2(3), 61-64. https://doi.org/10.11648/j.ccr.20180203.13

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ACS Style

Sane Rohit; Mandole Rahul. To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure. Cardiol. Cardiovasc. Res. 2018, 2(3), 61-64. doi: 10.11648/j.ccr.20180203.13

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AMA Style

Sane Rohit, Mandole Rahul. To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure. Cardiol Cardiovasc Res. 2018;2(3):61-64. doi: 10.11648/j.ccr.20180203.13

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@article{10.11648/j.ccr.20180203.13,
  author = {Sane Rohit and Mandole Rahul},
  title = {To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure},
  journal = {Cardiology and Cardiovascular Research},
  volume = {2},
  number = {3},
  pages = {61-64},
  doi = {10.11648/j.ccr.20180203.13},
  url = {https://doi.org/10.11648/j.ccr.20180203.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20180203.13},
  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, VO2peak (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 VO2peak (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.},
 year = {2018}
}

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TY  - JOUR
T1  - To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure
AU  - Sane Rohit
AU  - Mandole Rahul
Y1  - 2018/10/30
PY  - 2018
N1  - https://doi.org/10.11648/j.ccr.20180203.13
DO  - 10.11648/j.ccr.20180203.13
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 61
EP  - 64
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20180203.13
AB  - 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, VO2peak (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 VO2peak (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.
VL  - 2
IS  - 3
ER  -

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Author Information

Sane Rohit

Department of Research and Development, Madhavbaug Cardiac Care Clinics and Hospitals, Mumbai, India
Mandole Rahul

Department of Research and Development, Madhavbaug Cardiac Care Clinics and Hospitals, Mumbai, India

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APA Style

Sane Rohit, Mandole Rahul. (2018). To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure. Cardiology and Cardiovascular Research, 2(3), 61-64. https://doi.org/10.11648/j.ccr.20180203.13

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ACS Style

Sane Rohit; Mandole Rahul. To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure. Cardiol. Cardiovasc. Res. 2018, 2(3), 61-64. doi: 10.11648/j.ccr.20180203.13

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AMA Style

Sane Rohit, Mandole Rahul. To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure. Cardiol Cardiovasc Res. 2018;2(3):61-64. doi: 10.11648/j.ccr.20180203.13

Copy | Download

@article{10.11648/j.ccr.20180203.13,
  author = {Sane Rohit and Mandole Rahul},
  title = {To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure},
  journal = {Cardiology and Cardiovascular Research},
  volume = {2},
  number = {3},
  pages = {61-64},
  doi = {10.11648/j.ccr.20180203.13},
  url = {https://doi.org/10.11648/j.ccr.20180203.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20180203.13},
  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, VO2peak (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 VO2peak (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.},
 year = {2018}
}

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TY  - JOUR
T1  - To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure
AU  - Sane Rohit
AU  - Mandole Rahul
Y1  - 2018/10/30
PY  - 2018
N1  - https://doi.org/10.11648/j.ccr.20180203.13
DO  - 10.11648/j.ccr.20180203.13
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 61
EP  - 64
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20180203.13
AB  - 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, VO2peak (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 VO2peak (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.
VL  - 2
IS  - 3
ER  -

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