463 The Effect of Intervention of Medical Staff on the Adherence of CPAP and Heart Rate in Patients with Obstructive Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A182-A183
Author(s):  
Ryutaro Shirahama ◽  
Rie Ishimaru ◽  
Jun Takagiwa ◽  
Yasue Mitsukura
Keyword(s):  
Heart Rate ◽  
Medical Staff ◽  
Nervous Activity ◽  
Sympathetic Nervous Activity ◽  
Sleep Stages ◽  
Obstructive Sleep ◽  
Group A ◽  
Group B ◽  
Tele Monitoring ◽  
Mean Heart Rate

Abstract Introduction Recent studies have indicated that obstructive sleep apnea syndrome (OSAS) is associated with hypertension. OSA is a common cause of sympathetic nervous activity. Increase of sympathetic nervous activity causes hypertension. Continuous positive airway pressure (CPAP) is the most useful treatment for OSAS. Good CPAP adherence treatment improve the risk of hypertension. This study examined the effect of intervention of medical staff on the adherence of CPAP, heart rate and sleep stages in patients with OSA. Methods All patients diagnosed with OSA and undergoing subsequent CPAP were clinically followed for 12 months to examine CPAP adherence, as well as longitudinal changes in blood pressure, average heartrate of 24 hours and sleep stages. They were divided into 2 groups, Group A: patients who had individual consulted in person by sleep physician and technicians before start using CPAP and Group B: patents who did not have individual consulted. Patients in both groups were consulted by sleep physician and technicians after start CPAP with utilizing tele-monitoring. If the adherence were poor, the patients were recommended to stop CPAP. We provided 3D accelerometer and an optical pulse photoplethysmography to all the patients and analyzed the data of heart rate and sleep stages. Results A total of 30 OSA patients underwent CPAP, were enrolled in the study and assessed for changes in mean heart rate and body weight during the study period. We found a significant reduction in mean heart rate in both group A and B compared with baseline (p<-0.05). The patients aged under 50 years old and whose AHI<20 times/hour have higher ratio of dropout CPAP therapy. There was no significant difference between Group A and Group B on the persistency rate of CPAP therapy. Also, no significant association was found between group A and B on the adherence of CPAP. Conclusion We showed the importance of the effect of intervention of medical staff on the adherence of CPAP and heart rate in patients with OSA the consultation after starting CPAP for a while with utilizing tele-monitoring data would be more effective compared with that in person before start using CPAP. Support (if any):

Abstract 5430: Obstructive Sleep Apnoea Exacerbates Muscular Sympathetic Nervous Activity in Patients with Metabolic Syndrome

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ivani C Trombetta ◽  
Cristiane M Nunes ◽  
Luciano F Drager ◽  
Raffael F Fraga ◽  
Maria Janieire N Alves ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Nervous Activity ◽  
Sleep Apnoea ◽  
Sympathetic Nervous Activity ◽  
Obstructive Sleep ◽  
Sympathetic Nervous

Obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) independently increases muscular sympathetic nervous activity (MSNA). Unknown is whether OSA has an additive effect on MSNA in patients with MetS. We tested the hypothesis that: OSA would have an additive effect on MSNA in patients with MetS. In addition, we studied whether the increase in MSNA in patients with MetS is associated with alteration in arterial baroreflex sensitivity (BRS). Twenty four patients with MetS diagnosed according ATP-III were divided in two groups: MetS+OSA (n=14) and MetS (n=10). They were matched for age, body mass index, waist circumference, and metabolic profile: OSA was defined by an apnoea/hypopnoea index (AHI)>15 events/hour by polysonography. MSNA was recorded directly from the peroneal nerve using the technique of microneurography. Blood pressure (BP) was monitored on a beat-by-beat basis (Finapress) and heart rate by ECG. BRS was analyzed by spontaneous BP and heart rate fluctuations. AHI was higher (42±9 vs. 7±1 events/h, P =0.0001) and minimum oxygen saturation lower (77±2 vs. 87±1 %, P =0.001) in MetS+OSA patients. Patients MetS+OSA had higher MSNA (55±3 vs. 43±2 bursts/100 beats, P =0.01) and systolic BP (158±4 vs.144±3 mmHg, P =0.01) when compared with patients with MetS without OSA. Further analysis showed that AHI and minimum oxygen saturation have significant correlation with MSNA (r=0.65; P =0.001 and r=−0.48; P =0.017, respectively). Patients with MetS+OSA had lower BRS for increases (7.8±0.9 vs. 13.4 ± 1.4 msec/mmHg, P =0.01) and decreases (7.2±0.9 vs. 13.2 ± 2.0 msec/mmHg, P =0.03) in blood pressure than patients with MetS without OSA. MSNA significantly correlated with BRS during spontaneous increases in blood pressure (r=−0.56, P =0.01). OSA exacerbates MSNA in patients with MetS. In addition, the augmented MSNA in patients with MetS+OSA is associated with reduced BRS. These findings suggest that OSA increases the risk for cardiovascular disease in patients with MetS.

COMPARISON OF DEXMEDETOMIDINE AND FENTANYL ON INTUBATION CONDITIONS DURING AWAKE FIBREOPTIC BRONCHOSCOPIC INTUBATION- A RANDOMISED DOUBLE BLIND STUDY.

2021 ◽  
pp. 1-2
Author(s):  
Asha .A ◽  
E. Arunmozhi
Keyword(s):  
Heart Rate ◽  
Study Drug ◽  
Sedation Score ◽  
Double Blind ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Post Intubation ◽  
Ramsay Sedation Score ◽  
Mean Heart Rate

INTRODUCTION:Awake Fibreoptic Intubation is indicated in patients with anticipated diffcult airway, failed tracheal intubation, unstable cervical spine injury.Drugs used for conscious sediation includes Benzodiazepines, opioids, Propofol, either alone or in combination. All these drugs, though results in favourable intubating conditions, may also result in upper airway obstruction, hypoventilation, difcult airway instrumentation and oxygen desaturation. In order to address and overcome these issues, we compared the effects of parenteral dexmedetomidine and fentanyl on favourable conditions during awake breoptic bronchoscopic intubation. MATERIALS AND METHODS:A prospective,double blind,randomised study. 60 patients belonging to age group 25 to 60 years, ASA PS I & II posted for elective surgery under general anaesthesia with endotracheal intubation were randomly allocated into two groups, Group A(n=30) received injection dexmedetomidine, Group B(n=30) received injection fentanyl before awake breoptic bronchoscopic intubation. Hemodynamic parameters, cough score, postintubation tolerance score, ramsay sedation score were noted in both groups. The observed datas were analysed by SPSS version 21.0 software. RESULT: Demographic variable such as age,weight,ASA physical status were comparable in both the groups. The mean heart rate at 5mins,10mins after administration of study drug,intubation, 5mins postintubation are 76.73±5.51,73.63±5.99,76.37±8.11 and 75.03±7.94 respectively in Group A.The mean heart rate at 5mins,10mins after administration of study drug,intubation, 5mins postintubation are 78.57±5.04,76.93±5.11,103.30±4.21 and 99.37±4.02 respectively.The mean MAP at 5mins,10 mins after administration of study drug,intubation,5 mins post intubation are 86.80±2.33,85.77 ±2.56,87.83 ±5.73 and 87.30 ± 2.52mmHg respectively in Group A.The mean MAP at 5mins,10mins after administration of study drug,intubation,5 mins post intubation are 87.37±3.58,85.63 ±3.58,107.80 ±2.59 and 105.00 ±2.52 mmHg respectively. The post intubation SpO2 was 97.10 ±1.77 and 93.43± 1.17 % for Group A and Group B respectively.In Group A mean Ramsay sedation score is 2.87± 0.43 and in Group B the mean is 2.13 ±0.35. CONCLUSION:Dexmedetomidine group showed better hemodynamic stability and tolerance to awake endotracheal tube insertion through breoptic bronchoscope.Dexmedetomidine provides favourable intubating conditions during awake breoptic bronchoscope procedures with adequate sedation and without desaturation than fentanyl.

scholarly journals Comparison of outcome of salbutamol alone and salbutamol in combination with ipratropium bromide in acute asthma in children.

2020 ◽  
Vol 27 (06) ◽  
pp. 1103-1107
Author(s):  
Saima Jabeen Joiya ◽  
Muhammad Azam Khan ◽  
Farhan ul Haq ◽  
Zahid Ahmad
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Flow Rate ◽  
Ipratropium Bromide ◽  
Acute Asthma ◽  
Accessory Muscle ◽  
Group A ◽  
Asthma In Children ◽  
Group B ◽  
Mean Heart Rate

Objectives: Asthma affects about 15% of children while it is one of the commonest reason for admissions in pediatric emergencies and wards. We aimed this study to determine outcome of Salbutamol alone and salbutamol in combination with Ipratropium Bromide in acute asthma in children. Study Design: Randomized Controlled trial (RCT). Setting: Unit-II Department of Pediatric Medicine, Nishtar Medical College and Hospital, Multan. Period: 20th Nov 2017 to 30th June 2018. Material & Methods: The study consisted of 104 children, with 52 children each in Group ‘A’ and ‘B’ who were subjected to salbutamol alone and salbutamol in combination with Ipratropium bromide respectively. In both groups oxygen was administered via nasal prongs at a flow rate of 3L/minute. These children was monitored at 30 minutes interval for 2 hours (least value out of these 4 values was taken). Both groups were compared for outcome in terms of mean heart rate, respiratory rate, accessory muscle score, peak expiratory flow rate (PERF) percentage and SPO2. Results: Of these 104 study cases, 61 (58.7%) were boys while 43 (41.3%) were girls. Mean age of our study cases was noted to be 9.92 ± 3.01 years. Mild level of asthma severity was noted in 35 (33.7%) and moderate severity in 69 (66.3%). Mean heart rate in group A was noted to be 119.40 ± 12.22 and in group was 119.29 ± 8.51 beats per minute. (p=0.956). Mean respiratory rate in group A was 29.98 ± 4.00 while in group B was 27.88 ± 3.85 (p=0.000). Mean accessory muscle score in group  A was 0.537 ± 0.336 while in group B was 0.130 ± 0.030 (p = 0.000). Mean PEFR percentage in group A was 68.69 ± 18.64 while in group B was 87.12 ± 17.10 (p = 0.000). Mean SPO2 in group A was 96.15 ± 1.05 while it was 95.94 ± 1.29 (p = 0.362). Conclusion: Our study results have shown that nebulization of salbutamol in combination with Ipratropium Bromide is more effective in the management of children with acute asthma. It was safe, effective and reliable as there was no adverse side effect noted in our study. We recommend the use of this combination nebulization therapy in children with acute asthma.

scholarly journals Relationship of Thyroid Hormones with Heart Rate Variability

1970 ◽  
Vol 5 (1) ◽  
pp. 20-26
Author(s):  
Rassel Kabir ◽  
Noorzahan Begum ◽  
Sultana Ferdousi ◽  
Shelina Begum ◽  
Taskina Ali
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Negative Correlation ◽  
Nervous Activity ◽  
Antithyroid Drugs ◽  
Cross Sectional ◽  
Rr Interval ◽  
Group A ◽  
Serum Tsh ◽  
Mean Heart Rate

Background: Altered thyroid functions are associated with variation in autonomic regulation ofcardiovascular activity. Cardiac Autonomic Nervous Activity (CANA) can be assessed quantitativelyby analysis of Heart Rate Variability (HRV). Objective: To observe the relationship between CANAwith altered TSH and FT4. Methods: This cross sectional study was carried out in the Department ofPhysiology, BSMMU, Dhaka between1st July 2007 and 30th June 2008 on 60 patients with excessthyroid hormone (group B, aged 30-50 years). Based on treatment, 30 untreated newly diagnosedpatients were designated as group B1 and 30 patients under treatment with antithyroid drugs for atleast 2 months were included into group B2 in order to observe the effect of treatment. All thesepatients were selected from the Out Patient Department of Endocrinology wing of Department ofMedicine, BSMMU, Dhaka. Sociodemographically matched 20 apparently healthy euthyroid personswere selected for comparison (group A). To confirm thyroid status, serum TSH and serum FT4 levelswere measured by AxSym system and some of the spectral HRV parameters i.e.mean R-R interval,mean heart rate, variance, LF n.u, HF n.u and LF/HF ratio were assessed by recordings of ECG for 5minute (short term) with a polyrite. For statistical analysis Pearson’s correlation coefficient (r) test wasused. Results: With serum TSH level, the LF n.u. power and LF/HF ratio showed significant (p<0.05)positive correlations but HF n.u. power showed significant (p<0.05) negative correlation in group B1.But these three parameters showed non significant correlations with TSH in the other two groups (A,B2). Similarly with serum TSH level, variance and mean R-R interval showed negative and mean HRshowed positive correlation in group B1. In group A, all these parameters were positively correlatedwhereas in group B2, RR interval and variance were positively and mean HR was negatively correlated.All these correlations were statistically non significant. With serum FT4 levels, mean R-R and HF n.u.were negatively and mean heart rate, LFnu, LF/HF were positively correlated in all three groups butvariance showed positive in group A and negative correlation in B1 and B2. All these correlations werestatistically non significant. Conclusion: From this study it can be concluded that changes in autonomicnervous regulation are related to altered serum level of TSH and FT4 in hyperthyroids.Key words: HRV; LF; HF; RR interval; HyperthyroidDOI: 10.3329/jbsp.v5i1.5414J Bangladesh Soc Physiol. 2010 June; 5(1): 20-26

scholarly journals Effect of Pregabalin Use as Preemptive Analgesia after Abdominal Hysterectomy on Heart Rate and Arterial Pressure

2017 ◽  
Vol 2 (2) ◽  
pp. 98-102
Author(s):  
Kazi Nur Asfia ◽  
Moinul Hossain ◽  
AKM Aktaruzzaman ◽  
Mostofa Kamal ◽  
Mohammad Abdullah Yusuf ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Abdominal Hysterectomy ◽  
Preemptive Analgesia ◽  
Study Group ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Heart Rate

Background: Effect of pregabalin on heart rate and arterial pressure is important in its use as preemptive analgesia. Objective: The purpose of the present study was to evaluate the effect of pregabalin use as preemptive analgesia after abdominal hysterectomy on heart rate and arterial pressure.Methodology: This randomized double-blind placebo-controlled clinical trial was conducted in the Department of Anesthesia, Analgesia and Intensive Care Medicine, Banghabandhu Sheikh Mujib Medical University, Dhaka from July 2010 to June 2012 for a period of two years. Women aged between 40-60 years scheduled for abdominal hysterectomy under sub-arachnoid block were selected as study population for this study. A total of one hundred and twenty women meeting the above mentioned criteria were randomly allocated into two equal groups by card sampling. 120 cards, 60 for each group were prepared by another person who was not aware of the study. Group A was known as study group who were received 300mg oral pregnabin one hour before performance of SAB and group B was known as control group who were received matching placebo one hour before SAB. The patients were examined preoperatively and preoperative baseline parameters including heart rate, mean arterial pressure were recorded immediately before sub-arachnoid block (SAB). Patients were visited by the investigators at ½, 1, 2, 4, 12, and 24 h after operation. In each visit, heart rate and mean arterial pressure were measured and were recorded. Result: The present study was conducted on 120 women undergoing abdominal hysterectomy. Of them, 60 received preemptive single oral doses (300mg) Pregabalin (Group A) and the rest 60 received matching placebos (Group B) 1hr before surgery. The mean heart rate with SD before SAB was 79.4±4.7 and 90.5±5.7 in group A and B respectively (p=0.011). After 24 hours of operation the mean heart rate with SD was 73±5 and 85±4 in group A and B respectively (p= 0.043). The mean arterial pressure with SD before SAB was 94.3±5.3 and 95.8±20.4 in group A and B respectively (p=0.569). After 24 hours of operation the mean arterial pressure with SD was 89.4±4.45 and 96.1±2.56 in group A and B respectively (p <0.001). Conclusion: In conclusion the mean heart rate and arterial pressure are statistically significantly changes in the women after abdominal hysterectomy to whom pregabalin is used as preemptive analgesia. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2): 98-102

Does body position, age, and heart rate induce IOP’s changes?

2021 ◽  
pp. 112067212110233
Author(s):  
Marcelina Sobczak ◽  
Magdalena Asejczyk ◽  
Malwina Geniusz
Keyword(s):  
Heart Rate ◽  
Body Position ◽  
Age Groups ◽  
Cardiovascular Parameters ◽  
Entire Cohort ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Effect Of Age

Objectives: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. Methods: Seventy-two healthy adults were enrolled and classified into age groups: 20–30 years (group A), 31–40 years (group B), and 41–71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. Results: A significant difference between the IOPS and IOPL in the entire cohort was found ( p < 0.001). Regarding the age subgroups, a significant difference ( p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. Conclusion: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.

Modifying effects of the R389G β1-adrenoceptor polymorphism on resting heart rate and blood pressure in patients with obstructive sleep apnoea

2005 ◽  
Vol 110 (1) ◽  
pp. 117-123 ◽  
Author(s):  
Jan Börgel ◽  
Tino Schulz ◽  
Nina K. Bartels ◽  
Jörg T. Epplen ◽  
Nikolaus Büchner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Obstructive Sleep Apnoea ◽  
Nervous Activity ◽  
Sleep Apnoea ◽  
Cpap Therapy ◽  
Pressure Therapy ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

OSA (obstructive sleep apnoea) stimulates sympathetic nervous activity and elevates resting HR (heart rate) and BP (blood pressure). In the present study in a cohort of 309 untreated OSA patients, the resting HR and BP during the daytime were correlated with AHI (apnoea/hypopnea index) and compared with patients with R389R (n=162), R389G (n=125) and G389G (n=22) genotypes of the β1-adrenoreceptor R389G polymorphism. We analysed the impact of the genotype on the decline of HR and BP in a subgroup of 148 patients (R389R, n=86; R389G, n=54; G389G, n=8) during a 6-month follow-up period under CPAP (continuous positive airway pressure) therapy during which cardiovascular medication remained unchanged. In untreated OSA patients, we found an independent relationship between AHI and resting HR (β=0.096, P<0.001), systolic BP (β=0.09, P=0.021) and diastolic BP (β=0.059, P=0.016). The resting HR/BP, however, did not differ among carriers with the R389R, R389G and G389G genotypes. CPAP therapy significantly reduced HR [−2.5 (−1.1 to −4.0) beats/min; values are mean difference (95% confidence intervals)] and diastolic BP [−3.2 (−1.5 to −5.0) mmHg]. The decline in HR was more significantly pronounced in the R389R group compared with the Gly389 carriers [−4.1 (−2.3 to −5.9) beats/min (P<0.001) compared with −0.2 (2.1 to −2.6) beats/min (P=0.854) respectively; Student's t test between groups, P=0.008]. Diastolic BP was decreased significantly (P<0.001) only in Gly389 carriers (R389G or G389G) compared with R389R carriers [−5.0 (−2.3 to −7.6) mmHg compared with −2.0 (0.4 to −4.3) mmHg respectively]. ANOVA revealed a significant difference (P=0.023) in HR reduction between the three genotypes [−4.1 (±8.4) beats/min for R389R, −0.5 (±9.3) beats/min for R389G and +1.9 (±7.2) beats/min for G389G]. In conclusion, although the R389G polymorphism of the β1-adrenoceptor gene did not influence resting HR or BP in untreated OSA patients, it may modify the beneficial effects of CPAP therapy on these parameters.

scholarly journals COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Coronary Syndrome ◽  
Group A ◽  
Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

Heart Rate Variability During Early Mobilization in Patients with Acute Ischemic Stroke

2018 ◽  
Vol 80 (1-2) ◽  
pp. 50-54 ◽  
Author(s):  
Masafumi Nozoe ◽  
Miho Yamamoto ◽  
Miki Kobayashi ◽  
Masashi Kanai ◽  
Hiroki Kubo ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Nervous Activity ◽  
Early Mobilization ◽  
Sympathetic Nervous Activity ◽  
Parasympathetic Nerve ◽  
Significant Difference ◽  
Sympathetic Nervous

Autonomic dysfunction is one of the predictors of poor outcome in patients with acute ischemic stroke. We compared the heart rate variability (HRV) during early mobilization in patients with or without neurological deterioration (ND). We enrolled 7 acute ischemic patients with ND and 14 without ND and measured their HRV in the rest and mobilization by electrocardiography. There was a significant difference in sympathetic nervous activity during mobilization between the 2 groups. However, no significant differences in blood pressure, heart rate, and parasympathetic nerve activity were observed. In patients with acute ischemic stroke, it is likely that the increase in sympathetic nervous activity during mobilization is associated with ND.

A PROSPECTIVE CONSIDERATIONS AND COMPARATIVE EFFICACY BETWEEN IVABRADINE VS BETA BLOCKERS IN SOUTH INDIAN ACUTE CORONARY SYNDROME PATIENTS

2019 ◽  
pp. 193-195
Author(s):  
Hemanth Kumar Lekkala
Keyword(s):  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Beta Blockers ◽  
Statistical Significance ◽  
Reduced Ejection Fraction ◽  
Coronary Syndrome ◽  
Nyha Classification ◽  
South Indian ◽  
Group A ◽  
Group B

Objectives: the objective of this study was to assess the role of heart rate in acute coronary syndrome with reduced ejection fraction, to assess contraindications for beta blockers, to assess the tolerability between Ivabradine and Beta-Blockers, to assess efficacy between Ivabradine and Beta Blockers, to assess patient condition according to NYHA classification. Methods: A Prospective observational study was conducted for a duration of6 months Study population includes 100 patients in which Group A-50, Group B-50. We were selected the subjects according to inclusion and exclusion criteria. The patients were classified in one of four categories based on their symptoms in regards to normal breathing and varying degrees in shortness of breath by using (The New York Heart Association) NYHA Classification. Results: Majority of the patients were in age group between (55-64)(32%) years of age are highly affected with ACS. Prevalence of ACS is high in Rural (56%). Both drugs decreased the mean heart rate to 89.97±10.27 (Group-A) versus 86.76±13.14 (Group-B) beats per minute (P=0.24). The result obtained are clinically and statistically significant with statistical significance at P>0.05. Conclusion:  In the present study we considered and compared the efficacy between Ivabradine and Beta Blockers in south Indian acute coronary syndrome patients shows Ivabradine is as effective as betablockers in reduction of heart rate.    

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