Anand Chockalingam1, Senthil Kumar2, Mauricio Sendra Ferrer3, Saivaroon Gajagowni3, Maxwell Isaac3, Poorna Karuparthi2, Kul Aggarwal2, Selva Shunmugam4, Arul Amuthan5, Arpit Aggarwal6, Chetan P Hans3, Kiruba Krishnaswamy7, Smrita Dorairajan8, Zhenguo Liu3, Greg Flaker3. 1. Division of Cardiovascular Medicine, University of Missouri, Columbia, MO 65212, United States; Harry S. Truman Memorial Veterans Hospital, Columbia, MO, United States. Electronic address: chockalingama@health.missouri.edu. 2. Division of Cardiovascular Medicine, University of Missouri, Columbia, MO 65212, United States; Harry S. Truman Memorial Veterans Hospital, Columbia, MO, United States. 3. Division of Cardiovascular Medicine, University of Missouri, Columbia, MO 65212, United States. 4. Siddha Consultant of Health India Foundation Clinic for Integrated Siddha and Modern medicine, India. 5. Siddha Consultant, Department of Pharmacology, Melaka Manipal Medical College, India. 6. Department of Psychiatry, University of Missouri, Columbia, MO 65212, United States. 7. Department of Biomedical, Biological & Chemical Engineering, Division of Food Systems & Bioengineering (Food Science and Nutrition), University of Missouri, Columbia, MO 65211, United States. 8. Harry S. Truman Memorial Veterans Hospital, Columbia, MO, United States; Division of Nephrology, University of Missouri, Columbia, MO 65212, United States.
Abstract
BACKGROUND: Morbid obesity (BMI > 35 kg/m2 with comorbid conditions) is present in 25 - 35% of acute decompensated heart failure (AHF) patients. Prevalence of HF increases with duration of morbid obesity from 30% at 15 years to over 90% at 30 years. There is a need to develop pragmatic therapies that address the unique physical and mental challenges faced by obese AHF patients. Siddha is 5,000 year old Tamil Medicine using yoga and mind-body methods towards higher consciousness. Hunger gratitude Experience (HUGE) is intuitive Siddha fasting method which may improve in-hospital AHF outcomes independent of weight reduction. CASE SUMMARY: We present 5 cases of morbidly obese patients with cardiorenal syndrome (CRS) that began intermittent fasting either during their AHF hospitalization or in the outpatient setting for refractory symptoms despite hospitalization. Initiation of fasting correlated with reduction of respiratory distress and edema as well as improvements in psychological wellbeing and functional capacity. DISCUSSION: Siddha fasting mediates hemodynamic and anti-inflammatory effects through natural ketosis and psychological benefits through empowerment in AHF. Potential role of fasting in reducing myocardial workload, coronary steal, angina, volume overload, and CRS needs further study in cardiac patients. Published by Elsevier Inc.
BACKGROUND: Morbid obesity (BMI > 35 kg/m2 with comorbid conditions) is present in 25 - 35% of acute decompensated heart failure (AHF) patients. Prevalence of HF increases with duration of morbid obesity from 30% at 15 years to over 90% at 30 years. There is a need to develop pragmatic therapies that address the unique physical and mental challenges faced by obese AHF patients. Siddha is 5,000 year old Tamil Medicine using yoga and mind-body methods towards higher consciousness. Hunger gratitude Experience (HUGE) is intuitive Siddha fasting method which may improve in-hospital AHF outcomes independent of weight reduction. CASE SUMMARY: We present 5 cases of morbidly obese patients with cardiorenal syndrome (CRS) that began intermittent fasting either during their AHF hospitalization or in the outpatient setting for refractory symptoms despite hospitalization. Initiation of fasting correlated with reduction of respiratory distress and edema as well as improvements in psychological wellbeing and functional capacity. DISCUSSION: Siddha fasting mediates hemodynamic and anti-inflammatory effects through natural ketosis and psychological benefits through empowerment in AHF. Potential role of fasting in reducing myocardial workload, coronary steal, angina, volume overload, and CRS needs further study in cardiac patients. Published by Elsevier Inc.