ABSTRACT
Objectives The objective of this study was to assess the effects of home-based exercise training (HBET) on function and quality of life (QoL) in patients with pulmonary hypertension (PH). Methods A prospective, nonblinded, randomized clinical trial was carried out on 84 medically stable patients with PH belonging to any functional class or etiology and of either sex. Patients were randomized to either standard care or HBET. Both groups also received education using the Pulmonary Hypertension Manual (PulHMan). Outcomes included functional capacity from 6-min walk distance (6MWD), QoL using the Medical Outcomes Survey Short Form – 36, functional class (FC), and right heart indices (right ventricular systolic pressure [RVSP] and tricuspid annular plane systolic excursion [TAPSE]) and were assessed at entry and after 12 weeks. Results HBET improved 6MWD by 48.5 m and 13 m in the experimental and control groups, respectively (p < 0.001). QoL showed statistical improvements after HBET between the groups for the physical and mental components and for the various subdomains (except body pain). Furthermore, FC improved by one grade with HBET (p < 0.001). Conclusion HBET program improved functional capacity, QoL, and FC in patients with PH.
ABSTRACT
Aims: Patients with severe sepsis and septic shock often exhibit significant cardiovascular dysfunction. We designed the study with an aim to determine the severity of cardiac dysfunction in the different group of sepsis patients. Study Design: Single-center, cross-sectional study Place and Duration of Study: The study was carried out at Department of Cardiology, Kasturba Medical College and Hospital, Manipal from June 2011 to December 2012. Methodology: A total of 74 patients who were diagnosed with sepsis were enrolled in the study. All patients were subjected to routine analysis, laboratory test and echocardiogrphic assessment. Results: The patients were divided into 3 groups: sepsis group (n = 11), severe sepsis group (n =37) and septic shock group (n = 26). The mitral E/A value is significantly higher in patients with septic shock than that of the patients with sepsis (P = 0.04). The indices of right ventricular dysfunction did not show any significant difference in the patients with septic shock and that of sepsis. Conclusion: Left ventricular dysfunction may be considered prevalent in sepsis as per the significant E/A values. However, the other echocardiographic parameter should also be considered. This may even infer that cardiac dysfunction may not correlate with the severity of sepsis.