A new study looked at the long-term effects of yoga therapy to see if adding it as a supplemental treatment in the management of heart failure is beneficial.
Heart failure is a type of cardiovascular disease in which the heart muscle is either too weak or too stiff to efficiently pump blood, resulting in fluid buildup, shortness of breath, and other difficulties. The most commonly used categorization system for determining the severity of a patient's symptoms is the New York Heart Association (NYHA) Functional categorization system.
The NYHA system categorises patients into one of four groups based on their physical activity limits, with Class I being the least severe and Class IV being the most severe. Ejection fraction is also measured by clinicians to evaluate how efficiently the heart pumps blood.
The study comprised 75 heart failure patients who had undergone coronary intervention, revascularization, or device therapy over the previous six months to one year at a tertiary care centre in South India. The study's patients were all less than or equivalent to NYHA Class III and had been on optimised medical therapy for at least 6 months to one year.
Patients had to be between 30 and 70 years old and have a left ventricular ejection fraction (LVEF) of 45 per cent to be eligible for the trial.
The interventional group had 35 participants (31 males and 4 women), while the non-interventional group had 40 (30 men and 10 women). The interventional group received yoga therapy as well as standard guideline-directed medical care, whereas the non-interventional group only received standard guideline-directed medical therapy.
To assess the impact of yoga therapy on heart failure patients, echocardiographic parameters were examined at various follow-ups.
The interventional group included 35 participants (31 men and 4 women) and 40 (30 men and 10 women) were in the non-interventional group. The interventional group received yoga therapy and guideline-directed medical therapy, while the non-interventional group only continued with standard guideline-directed medical therapy.
Echocardiographic parameters were compared at various follow-ups to see the impact of yoga therapy on heart failure patients.
“Yoga is a combination of mind-body techniques, which is a set of physical exercises [asana] with breathing techniques [pranayama], relaxation and meditation that can be effectively used to stimulate physical and mental well-being,” said Ajit Singh, PhD, research scientist for the Indian Council for Medical Research at Kasturba Medical College & Hospital, Manipal Academy of Heart Education in Manipal, India, and the study’s lead author.
“Our patients observed improvement in systolic blood pressure and heart rate compared to patients who were on medication without yoga.”
Participants in the yoga group were taken to the Department of Yoga at the hospital and an experienced yoga therapist taught selected yoga therapy like pranayama, meditation and relaxation techniques. Each session lasted around 60 minutes and participants were supervised for one week at the training center before being asked to continue self-administered yoga at home.
Those in the yoga group were advised to perform yoga at least five days a week for 12 months. At the training centre, all the participants were taught together to perform the same steps, but individual support was available.
Researchers measured quality of life improvements using the World Health Organization Quality of Life questionnaire, which uses 26 questions to evaluate quality of life in four aspects: physical, psychological, social and environmental health. The participants completed the questionnaire at enrollment, as well as at 24 weeks and 48 weeks of follow-up.
According to the researchers, the study showed participants in the yoga group had improvement in endurance, strength, balance, symptom stability and quality of life. They also observed that while patients improved physically and psychologically, there was no improvement in social and environmental health.
Echocardiographic parameters did not show any significant differences between the two groups at baseline. At both the six- and 12-month follow-up improved biventricular systolic function was seen in the interventional (yoga) group compared to the non-interventional group. The interventional group also showed substantial improvement in functional outcomes as assessed by the NHYA classification.
“This study proves that the addition of yoga therapy to standard medical management of heart failure leads to an improvement in left ventricular systolic function and quality of life in heart failure patients,” Singh said.
“Hence, yoga therapy may improve physical well-being and left ventricular function among heart failure patients on guideline-directed optimal medical therapy.”
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