The increased resting heart rate (HR) in heart transplant patients is associated with enhanced metabolic demand, the potential for fatigue, and lower quality of life. In the present study, we hypothesized that transcutaneous electrical acupoint stimulation (TEAS) could modulate autonomic balance and reduce resting HR in these patients. A single-arm clinical trial was conducted with patients aged > 18 years, at ambulatorial accompaniment after heart transplantation, who were submitted to a single TEAS (40 minutes at pericardium channel acupoints PC5 and PC6). The arterial blood pressure and RR interval were recorded from 20 minutes before to 20 minutes after TEAS. The RR intervals were used to calculate HR variability (HRV) and the sympathovagal index. Linear mixed models were used for comparing variables before, during, and after TEAS. The significance level was set as P < 0.05. TEAS acutely improved HRV in transplant patients and enhanced the sympathovagal index during its application.

Acupuncture, for the westerns countries, is an innovative and low-cost therapy for treatment and prevention of CVDs. However, most of its effects and mechanisms are poorly understood. Thus, the objective of this work was to systematically review the literature regarding the clinical effects of acupuncture for the treatment and prevention of cardiovascular diseases (CVDs). A search for papers published, in English or Portuguese ​​in the past 20 years, was conducted at PubMed, SciELO, and PEDro databases. Clinical trials conducted on the effects of acupuncture were included in this review. Two reviewers extracted the data independently remaining seventeen articles after screening. The most used acupoint was PC6 (10 studies, 64.7%), followed by ST36 (6 studies, 35.3%), and auricular acupoints (4 studies, 23.5%). Among the clinical applications, hypertension was the most studied CVD, with acupuncture being the most reported method among the studies (70.6%). Only 3 articles reported no benefit in the treatment of CVDs for the methodology used. We conclude that, although several studies indicated an improvement in the response of the cardiovascular system in CVDs by acupuncture, EA, or electrostimulation treatment, the heterogeneity of the studies does not allow a standardization of its application for each specific disease, making further studies necessary for its use to become a reality.

Introduction Heart rate control by the autonomic nervous system (ANS) is impaired in heart transplant (HT) recipients, leading to increased resting heart rate, metabolic demand, and fatigue, which can impair their quality of life (QoL). In this study, we hypothesized the association of hemodynamics and autonomic function as predictors of QoL in HT recipients. Methods This is a cross-sectional study conducted with HT recipients aged ≥ 18 years at ambulatorial accompaniment. Blood pressure was used for hemodynamics assessment, and heart rate variability (HRV) was used for ANS assessment. QoL was assessed by the 36-item Short Form Health Survey. The significance level was set as P≤0.05. Results Twenty-two volunteers were included in the study. Systolic blood pressure (SBP) and double product (DP) were significantly negatively associated with the physical functioning domain of QoL. DP, the number of consecutive normal RR interval differences > 50 ms (NN50), and the percentage of normal RR intervals that differed by > 50 ms from the adjacent interval (PNN50) exhibited negative association with the physical role domain. NN50 and PNN50 were significantly associated with bodily pain, social functioning, and emotional role domains. SBP was negatively associated with the vitality domain. Considering general and mental health domains, no variable demonstrated significant association. DP, NN50, and PNN50 were negatively associated with the total score of QoL. Conclusion This study demonstrated DP and HRV as predictors of QoL in HT recipients. These innovative results can become a relevant therapeutic target for improving QoL in HT recipients prior to its deterioration.

Objective: Severe mitral valve insufficiency may lead to heart failure and associated hemodynamic repercussions, such as congestion and weaning-induced pulmonary oedema. This slows weaning from mechanical ventilation, increases the length of the hospital stay, and worsens the patient's prognosis. Case report: The present report describes one strategy used for cardiopulmonary rehabilitation and to help wean a patient from mechanical ventilation, with prohibitive comorbidities that contra-indicate surgical mitral valve repair, using respiratory and peripheral muscle training associated with positive pressure ventilation. Discussion: The severe dysfunction of the mitral valve was considered to be surgically inoperable by the surgeon team. However, the weaning and rehabilitation challenges in this patient with severe chronic obstructive pulmonary disease, even with weaning-induced pulmonary edema occurrence, were overcome. The strategy to rehabilitate respiratory muscle force during positive pressure ventilation, concomitantly to a cardiopulmonary rehabilitation program, improved peripheral muscle strength and functionality, reducing energetic demand, allowing the weaning from mechanical ventilation. Conclusion: Despite the severity of the disease, with the adopted strategy it was possible to perform weaning of the mechanical ventilation, allowing the patient to survive with his relatives.