Failure Society of America 14th Annual Scientific Meeting
SAN DIEGO — Twelve weeks of tai chi significantly improved quality-of-life scores in patients with systolic HF when compared with patients in an education attention control, new study data suggested.
The study included patients (n=100) with left ventricular ejection fraction of 40% or less who were split evenly into two arms: those who performed tai chi (1 hour, twice a week) for 12 weeks and those who attended an education class for the same timeframe. Researchers performed baseline, 6- and 12-week testing, which included questionnaires and functional tests. Exclusion criteria included unstable angina, MI, cardiac surgery or cardiac resynchronization therapy in the preceding 3 months, as well as cardiac arrest or new diagnosis of peripartum cardiomyopathy 6 months beforehand.
According to study data, adherence at classes was 75% in the tai chi group and 67% in the educational group. Participants of tai chi at 12 weeks experienced an improvement in median Minnesota Living with Heart Failure quality-of-life score of 19 points, whereas the score for those in the educational group did not change (P=.02). For the 6-minute walk test, the tai chi group improved its walking distance by about 35 m, whereas the control group did not improve. This difference, however, was not statistically significant, nor was the change in peak oxygen uptake between the two groups.
Additional study findings indicated that with the exception of arrhythmias, adverse events such as death, CV hospitalizations and syncope were lower in the tai chi group.
According to Gloria Yeh, MD, with Beth Israel Deaconess Medical Center in Boston, and study researcher, possible mechanisms for the favorable results of tai chi include: physical activity with training effect; the relaxation/stress-reduction, which acted on stress-related neuromodulators; the meditation and mind-body integration training, which affected autonomic tone; the breathing retraining, which decreased perceived dyspnea; and the attention and social support intrinsic to tai chi.
“Training in mind and body integration may improve quality of life and facilitate increased activity in HF,” Yeh said in her presentation. “Future research should further address physiological mechanisms, a better understanding of multiple components and define the population most likely to benefit from mind and body interventions.”
Ileana Piña, MD, professor of medicine at Case Western Reserve University, Cleveland, and Cardiology Today Editorial Board member, said in the presentation’s commentary that the greatest benefit of tai chi may actually be in the sickest groups.
Regarding other directions that Piña said she would like to see future research take, she added, “I would like to see the inclusion of more women in this age group, who have a very difficult time with cardiac rehab programs, and to do a comparison with standard exercise training type of approach. Quantifying the standard metabolic equivalent level of training I think is also important to see how much the intensity is and taking it to the community setting.” – by Brian Ellis
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