Dr. Amit Shah, MD, MSCR


 

Effect of Heart Rate Variability Biofeedback on Myocardial Blood Flow in Patients With Coronary Artery Disease: a Randomized Controlled Pilot Trial

Myocardial blood flow may decrease during acute mental stress via vasoconstriction. In a randomized controlled pilot trial, we explored the hypothesis that HRVB, versus waitlist control, increases mental stress myocardial blood flow (MBF) in subjects with coronary artery disease (CAD). We randomized 24 subjects with CAD to HRVB vs. waitlist control. HRVB training lasted 6 weeks, including 3 phone-based and 3 in-person weekly coaching sessions. Myocardial blood flow was quantified with Rb-82 Positron Emission Tomography at baseline and 8 weeks after enrollment. An arithmetic stress challenge was performed in the scanner to induce acute mental stress, and the mental stress myocardial flow reserve (MS-MFR) was calculated as the ratio of MBF during stress divided by rest. Of the 24 patients randomized, 21 had both baseline and follow-up MBF data and were included in the analysis. In the HRVB group (n=12), the MS-MFR increased from 0.96 at baseline to 1.12 at follow-up (difference of 0.16, 95% C.I. 0.06 – 0.27, p<0.01). In the control group (n=9), no significant difference in MS-MFR was found between baseline and follow-up. No differences were found in hemodynamic responses to stress or depressive symptoms.

About Dr. Shah

Amit Shah, MD, MSCR is an Assistant Professor of Epidemiology with an adjunct appointment in Medicine (Cardiology) at Emory University. He also practices general cardiology at the Atlanta VA Medical Center, where he is director of the cardiac rehabilitation program and prevention.

Dr. Shah’s primary research focus is in understanding the relationship between psychological factors and heart disease, although he has a variety of other interests, including: ECG signal processing, non-invasive cardiac imaging, cardiac physiology, cardiac arrhythmia, integrative medicine, mobile health technologies, and risk prediction.

Since Dr. Shah joined the faculty in 2013, he has been continuously funded by the American Heart Association, Georgia Research Alliance, Coulter Foundation, and National Institutes of Health. He has won several awards from the American Heart Association for his research, and published in several high-impact journals, including JAMA Psychiatry and JAMA Cardiology.

Maggie Johnson, PhD


 

Poster Presentation: Effect of Heart Rate Variability Biofeedback Stress Reduction Intervention with Coronary Artery Disease: A mixed-methods qualitative program evaluation.

About Dr. Johnson

Dr. Johnson is a clinical psychologist in the Health Psychology Clinic at the Atlanta VA Medical Center where she provides behavioral health interventions to veterans coping with chronic illness, cardiovascular disease, and chronic pain. Dr. Johnson provides both group and individual interventions using mindfulness-based therapies, motivational interviewing, Cognitive Behavioral Therapy (CBT), and Acceptance and Commitment Therapy (ACT). She also participates as a health coach in the home-based cardiac rehabilitation program, where she assists veterans in managing their risk factors, making lifestyle changes, and stress management. Her professional interests include stress and chronic illness, behavioral medicine, treatment of anxiety and depression, pain management, cardiovascular diseases, cardiac rehabilitation, smoking cessation, biofeedback, mindfulness-based therapies, and research/program development.
   

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