WHAT Evaluation of the cardiovascular and psychological effects of live music in patients hospitalised with acute myocardial infarction in the Coronary Unit.
WHO Principal investigator, Dr. Roberto Martín Asenjo, specialist in Cardiology at Hospital 12 de Octubre.
WHY Patients hospitalised for acute myocardial infarction experience psychological and physiological reactions that can alter their vital signs. It has been proven that the presence of high heart rate (HR), high blood pressure, high incidence of ventricular extrasystoles and low HR variability are associated with a higher risk of mortality in patients hospitalised for acute myocardial infarction. Therefore, the reduction of heart rate and blood pressure are priority objectives of pharmacological treatment in the acute phase of infarction. This study is based on the evidence that music is a stimulus capable of modulating emotions and moods, and that it is capable of bringing about changes in brain structures that modulate cardiac activity (hypothalamus, amygdala, insular and orbitofrontal cortex).
HOW By searching for evidence on the ability of live music to reduce blood pressure, heart rate and the incidence of ventricular extrasystoles, as well as improve heart rate variability in patients during the acute phase of myocardial infarction. The study also analysed whether live music improves patient and family satisfaction during admission to the Coronary Unit.
WHEN This study was carried out from September 2017 to June 2018.
Situation of the patients
The participants in the study were patients admitted to the Coronary Unit after suffering a heart attack, a situation in which patients abruptly go from being in a normal state of health to being in a very serious condition that can even compromise their life. This has a very important psychological impact on patients. Additionally, admission generates stress and anxiety, which induces changes in certain physiological variables such as blood pressure and heart rate, adversely affecting the heart of the patient suffering a heart attack. These were generally young patients. “We avoided more delicate and more compromised patients, with symptoms at that time or in discomfort, or who had to undergo a specific procedure or intervention,” explained the research team. “We chose patients who were stable, and who could not receive family visits during their stay, in other words they were alone.”
The project was carried out in the Coronary Unit after the patient had already started in Intensive Care, with which the Coronary Unit shared the same space. “The music interventions were performed directly for specific patients. Behind closed doors and room by room, hence the emphasis on privacy, so that the musicians were not in the middle of the unit with other patients who were not participating in the study. We did it this way but a different approach could be used. All that would change would be the control method. This approach was good in my opinion”, states Martín Asenjo, the principal investigator in this clinical study.
-To study the variations in heart rate and blood pressure during a live music performance in the acute phase of myocardial infarction.
-To assess the impact on the well-being and satisfaction of acute coronary syndrome patients admitted to the Coronary Unit and their relatives.
The data were still being analysed at the time of publication of this White Paper.
According to Dr. Martín Asenjo, head of the Cardiology department and principal investigator on the project: “Beyond the results of the measurements of physiological variables or the administered questionnaire, the experience was very positive, since the music performances were seamlessly integrated in clinical practice, and also had an impact on the well- being of staff. After this pilot experience, we believe that the integration of such interventions in daily care in a cardiovascular critical care unit would be feasible and would have a positive impact on both the work environment and the well-being of patients and their relatives.”