1 798 137 EFFECT OF YOGA LIFESTYLE IN PATIENTS WITH HEART FAILURE: A RANDOMIZED CONTROL TRIAL. BACKGROUND: IN SPITE OF SIGNIFICANT ADVANCES IN THE MANAGEMENT OF HEART FAILURE (HF), MORBIDITY AND MORTALITY REMAIN HIGH. THEREFORE, THERE IS A NEED FOR ADDITIONAL STRATEGIES. WE DID A RANDOMIZED CLINICAL TRIAL TO STUDY EFFECT OF YOGA IN PATIENTS WITH HF IN TERMS OF QUALITY OF LIFE (QOL), LEFT VENTRICLE EJECTION FRACTION (LVEF), C-REACTIVE PROTEIN (CRP), AND NTPROBNP. MATERIALS AND METHODS: 60 PATIENTS WITH STABLE HF NEW YORK HEART ASSOCIATION CLASS II WITH LVEF 30%-40% WERE RANDOMIZED INTO CONTROL GROUP (CG) AND YOGA GROUP (YG). CG RECEIVED THE GUIDELINE-BASED THERAPY AND YG IN ADDITION PRACTICED THE YOGA, ONE HOUR DAILY FOR 3 MONTHS. ALL PATIENTS WERE ASSESSED FOR QOL, CRP, NTPROBNP, AND LVEF AT BASELINE AND AFTER 3 MONTHS. RESULTS: A SIGNIFICANT DIFFERENCE WAS OBSERVED IN ALL FOUR PARAMETERS IN THE YG AS COMPARED TO THE CG (P < 0.01) AFTER 12 WEEKS. QOL AS ASSESSED BY MINNESOTA LIVING WITH HEART FAILURE QUESTIONNAIRE SCORE IMPROVED SIGNIFICANTLY IN YG AS COMPARED TO CG (10 V/S 14, P < 0.001). THERE WAS A SIGNIFICANT IMPROVEMENT WITHIN YG IN TERMS OF LVEF (33.4-36.8, P = 0.001), AND THE PERCENTAGE CHANGE IN LVEF WAS SIGNIFICANT BETWEEN THE GROUPS (10% V/S 5%, P = 0.001). NTPROBNP ALSO SIGNIFICANTLY REDUCED BY 69.8% FROM 755 TO 220 PMOL/L IN YG AS COMPARED TO 39.3% IN CG (679-406 PMOL/L). CRP DECREASED BY 49.3% (5.36-2.73 MG/L) IN YG AND 35.8% (5.39-3.45 MG/L) IN CG. CONCLUSION: THE RESULT OF THIS PILOT STUDY SUGGESTS THAT ADDITION OF YOGA TO GUIDELINE-BASED THERAPY FOR HF PATIENTS SIGNIFICANTLY IMPROVES QOL, LVEF, AND NTPROBNP AND REDUCES CRP LEVEL. LARGER STUDIES ARE NEEDED TO CONFIRM THESE FINDINGS. 2022 2 989 36 EFFECTS OF HATHA YOGA ON CARDIAC HEMODYNAMIC PARAMETERS AND PHYSICAL CAPACITY IN CARDIAC REHABILITATION PATIENTS. PURPOSE: THE PURPOSE OF THE PRESENT STUDY WAS TO ASSESS THE EFFECT OF HATHA YOGA TRAINING THAT WAS ADDED TO THE STANDARD CARDIAC REHABILITATION (CR) PROGRAM ON THE CARDIAC HEMODYNAMIC PARAMETERS AND PHYSICAL CAPACITY OF PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION (STEMI). METHODS: THE STUDY INCLUDED 70 MALE PATIENTS AGED 45-65 YR WITH STEMI WHO WERE TREATED BY ANGIOPLASTY. PATIENTS WERE RANDOMIZED TO STANDARD CR (CONTROL GROUP) VERSUS STANDARD CR PLUS HATHA YOGA (EXPERIMENTAL GROUP). THE TRAINING PROGRAM LASTED FOR A TOTAL OF 24 D FOR EACH PATIENT, WITH DAY 1 AND DAY 24 USED FOR MEDICAL EXAMINATIONS (ELECTROCARDIOGRAM, SPIROERGOMETRIC SUBMAXIMAL TREADMILL TEST, AND ECHOCARDIOGRAPHY). THE REMAINING 22 D CONSISTED OF THE ACTUAL TRAINING. RESULTS: AFTER THE CR PROGRAM THE SPIROERGOMETRIC STRESS TEST PARAMETERS AND LEFT VENTRICULAR EJECTION FRACTION (LVEF) IMPROVED IN BOTH THE EXPERIMENTAL AND CONTROL GROUPS. THE MOST NOTABLE CHANGES IN ECHOCARDIOGRAPHY PARAMETERS AND PHYSICAL CAPACITY WERE IN THE EXPERIMENTAL GROUP. THE RESULTS SHOWED SIGNIFICANT MAIN EFFECT OVER TIME, A TIME-VERSUS-GROUP INTERACTION IN LVEF, THE DURATION OF THE TEST, AND PEAK OXYGEN UPTAKE, AND A TIME-VERSUS-GROUP INTERACTION IN METABOLIC EQUIVALENTS (METS). WE ALSO NOTED THE IMPROVEMENT OF LEFT VENTRICULAR END-DIASTOLIC DIAMETER, LEFT VENTRICULAR END-SYSTOLIC DIAMETER, AND HEART RATE OVER TIME. CONCLUSION: THE RESULTS REVEALED BETTER EFFECTIVENESS IN THE CR PROGRAM WITH A MODIFIED HATHA YOGA TRAINING PROGRAM. HATHA YOGA TRAINING COULD BE RECOMMENDED AS AN ADJUNCT TO STANDARD CR. 2020 3 1477 54 INTEGRATED YOGA PRACTICE IN CARDIAC REHABILITATION PROGRAM: A RANDOMIZED CONTROL TRIAL. BACKGROUND: CORONARY ARTERY DISEASE (CAD) IS A DETRIMENTAL NONCOMMUNICABLE DISEASE, WHICH IS INCREASING DUE TO SEDENTARY LIFESTYLE AND URBANIZATION IN THE YOUNG POPULATION. IT IS FURTHER ELEVATED WITH RISK FACTORS SUCH AS STRESS, ANXIETY, DEPRESSION, AN INCREASE IN TRIGLYCERIDES, DYSLIPIDEMIA, HYPERGLYCEMIA, HYPERTENSION, AND SO ON, WHICH MANIFESTS AS ATHEROSCLEROTIC DISEASE. YOGA-BASED LIFESTYLE INTERVENTION IS A NONINVASIVE EFFECTIVE TREATMENT METHOD TO CONTROL AND PREVENT CARDIAC RISK FACTORS IN CAD PATIENTS. YOGA HAS BEEN USED IN INDIA AS A THERAPEUTIC METHOD TO MANAGE HYPERTENSION AND OTHER CHRONIC DISORDERS AND IS FAST GAINING POPULARITY AS AN EFFECTIVE MEANS FOR THE ALLEVIATION OF STRESS, IMPROVEMENT OF FITNESS, AND ENHANCEMENT OF WELL-BEING. THIS STUDY AIMED TO DETERMINE THE FEASIBILITY OF INTRODUCING THE INTEGRATED APPROACH OF YOGA THERAPY (IAYT) IN A CARDIAC REHABILITATION CENTER IN INDIA AND UNDERSTAND ITS USEFULNESS IN IMPROVING THE CARDIAC FUNCTION AND MANAGING THE CARDIAC RISK FACTORS IN ACUTE MYOCARDIAL INFARCTION PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION. METHODS AND DESIGN: CARDIAC PATIENTS WERE RANDOMIZED TO A YOGA-PRACTICING GROUP (N = 33) AND A CONTROL GROUP (N = 33). THE YOGA-PRACTICING GROUP WAS INSTRUCTED TO ATTEND THREE SUPERVISED IAYT CLASSES 3 DAYS PER WEEK FOR 12 WEEKS AT THE HOSPITAL YOGA CENTER. THE CONTROL GROUP RECEIVED STANDARD CARE THAT INCLUDED PHARMACOLOGIC TREATMENT AND THE INSTRUCTIONS OF THE CARDIOLOGIST. THE OUTCOME MEASURES WERE ASSESSED AT BASELINE (T1 = 0) AND COMPLETION (T2 = 3 MONTHS). THE PRIMARY OUTCOME MEASURE WAS THE LEFT VENTRICULAR EJECTION FRACTION (LVEF). RESULTS: THERE WAS NO STATISTICALLY SIGNIFICANT DIFFERENCE IN LVEF (U = 420.500, P VALUE = 0.218) BETWEEN THE TWO GROUPS. HOWEVER, THE YOGA-PRACTICING GROUP SHOWED SIGNIFICANT REDUCTION IN DEPRESSION (CARDIAC DEPRESSION SCALE [CDS], U = 71, P VALUE = 0.0), ANXIETY (HAMILTON ANXIETY RATING SCALE [HAM-A], U = 128, P VALUE = 0.0), AND A SIGNIFICANT INCREASE IN QUALITY OF LIFE (QOL) SCORES (DUKE ACTIVITY STATUS INDEX [DASI], U = 146, P VALUE = 0.0; AND METABOLIC EQUIVALENTS (METS), U = 136, P VALUE = 0.0) AT 3 MONTHS COMPARED TO CONTROL. OVERALL, THE CAD PATIENTS PRACTICING YOGA SHOWED A FAVORABLE PROFILE COMPARED TO CONTROL INDIVIDUALS ON CDS, HAM-A, DASI, AND MET OUTCOMES. CONTROL AND YOGA PRACTICING GROUPS DID NOT DIFFER SIGNIFICANTLY IN THE LIPID LEVELS. CONCLUSION: THIS STUDY INDICATED THAT THE INTEGRATION OF YOGA PRACTICE IN A CARDIAC REHABILITATION PROGRAM IS FEASIBLE AND HAS NO ADDED BENEFIT IN IMPROVING THE CARDIAC FUNCTION. HOWEVER, THE ADDITION OF YOGA TO CARDIAC REHABILITATION MAY BE BENEFICIAL IN REDUCING DEPRESSION AND ANXIETY AND IMPROVING QOL IN PATIENTS. 2020 4 2394 41 YOGA AND BREATHING TECHNIQUE TRAINING IN PATIENTS WITH HEART FAILURE AND PRESERVED EJECTION FRACTION: STUDY PROTOCOL FOR A RANDOMIZED CLINICAL TRIAL. BACKGROUND: CURRENT THERAPIES FOR HEART FAILURE (HF) ARE FOLLOWED BY STRATEGIES TO IMPROVE QUALITY OF LIFE AND EXERCISE TOLERANCE, BESIDES REDUCING MORBIDITY AND MORTALITY. SOME HF PATIENTS PRESENT CHANGES IN THE MUSCULOSKELETAL SYSTEM AND INSPIRATORY MUSCLE WEAKNESS, WHICH MAY BE RESTORED BY INSPIRATORY MUSCLE TRAINING, THUS INCREASING RESPIRATORY MUSCLE STRENGTH AND ENDURANCE, MAXIMAL OXYGEN UPTAKE (VO2), FUNCTIONAL CAPACITY, RESPIRATORY RESPONSES TO EXERCISE, AND QUALITY OF LIFE. YOGA THERAPIES HAVE BEEN SHOWN TO IMPROVE QUALITY OF LIFE, INFLAMMATORY MARKERS, AND PEAK VO2 MOSTLY IN HF PATIENTS WITH A REDUCED EJECTION FRACTION. HOWEVER, THE EFFECT OF DIFFERENT YOGA BREATHING TECHNIQUES IN PATIENTS SHOWING HF WITH A PRESERVED EJECTION FRACTION (HFPEF) REMAIN TO BE ASSESSED. METHODS/DESIGN: A PROBE (PROSPECTIVE RANDOMIZED OPEN BLINDED END-POINT) PARALLEL-GROUP TRIAL WILL BE CONDUCTED AT TWO SPECIALIZED HF CLINICS. ADULT PATIENTS PREVIOUSLY DIAGNOSED WITH HFPEF WILL BE INCLUDED. AFTER SIGNING INFORMED CONSENT AND PERFORMING A PRE-TEST INTERVENTION, PATIENTS WILL BE RANDOMIZED INTO THREE GROUPS AND PROVIDED WITH EITHER (1) ACTIVE YOGA BREATHING TECHNIQUES; (2) PASSIVE YOGA BREATHING TECHNIQUES (PRANAYAMA); OR AND (3) CONTROL (STANDARD PHARMACOLOGICAL TREATMENT). FOLLOW-UP WILL LAST 8 WEEKS (16 SESSIONS). THE POST-INTERVENTION TESTS WILL BE PERFORMED AT THE END OF THE INTERVENTION PERIOD FOR ANALYSIS OF OUTCOMES. INTERVENTIONS WILL OCCUR CONTINUOUSLY ACCORDING TO PATIENTS' ENROLLMENT. THE MAIN OUTCOME IS RESPIRATORY MUSCULAR RESISTANCE. A TOTAL OF 33 ENROLLED PATIENTS ARE EXPECTED. THE PRESENT PROTOCOL FOLLOWED THE SPIRIT GUIDELINES AND FULFILLED THE SPIRIT CHECKLIST. DISCUSSION: THIS TRIAL IS PROBABLY THE FIRST TO ASSESS THE EFFECTS OF A NON-PHARMACOLOGICAL INTERVENTION, NAMELY YOGA AND SPECIFIC BREATHING TECHNIQUES, TO IMPROVE CARDIORESPIRATORY FUNCTION, AUTONOMIC SYSTEM, AND QUALITY OF LIFE IN PATIENTS WITH HFPEF. TRIAL REGISTRATION: REBEC IDENTIFIER: RBR-64MBNX (AUGUST 19, 2012). CLINICAL TRIALS REGISTER: NCT03028168 . REGISTERED ON 16 JANUARY 2017). 2018 5 867 44 EFFECT OF YOGA REGIMEN ON LUNG FUNCTIONS INCLUDING DIFFUSION CAPACITY IN CORONARY ARTERY DISEASE PATIENTS: A RANDOMIZED CONTROLLED STUDY. BACKGROUND: LUNG FUNCTIONS ARE FOUND TO BE IMPAIRED IN CORONARY ARTERY DISEASE (CAD), CONGESTIVE HEART FAILURE, LEFT VENTRICULAR DYSFUNCTION, AND AFTER CARDIAC SURGERY. DIFFUSION CAPACITY PROGRESSIVELY WORSENS AS THE SEVERITY OF CAD INCREASES DUE TO REDUCTION IN LUNG TISSUE PARTICIPATING IN GAS EXCHANGE. AIMS AND OBJECTIVES: PRANAYAMA BREATHING EXERCISES AND YOGIC POSTURES MAY PLAY AN IMPRESSIVE ROLE IN IMPROVING CARDIO-RESPIRATORY EFFICIENCY AND FACILITATING GAS DIFFUSION AT THE ALVEOLO-CAPILLARY MEMBRANE. THIS STUDY WAS DONE TO SEE THE EFFECT OF YOGA REGIMEN ON LUNG FUNCTIONS PARTICULARLY DIFFUSION CAPACITY IN CAD PATIENTS. MATERIALS AND METHODS: A TOTAL OF 80 STABLE CAD PATIENTS BELOW 65 YEARS OF AGE OF BOTH SEXES WERE SELECTED AND RANDOMIZED INTO TWO GROUPS OF 40 EACH. GROUP I CAD PATIENTS WERE GIVEN YOGA REGIMEN FOR 3 MONTHS WHICH CONSISTED OF YOGIC POSTURES, PRANAYAMA BREATHING EXERCISES, DIETARY MODIFICATION, AND HOLISTIC TEACHING ALONG WITH THEIR CONVENTIONAL MEDICINE WHILE GROUP II CAD PATIENTS WERE PUT ONLY ON CONVENTIONAL MEDICINE. LUNG FUNCTIONS INCLUDING DIFFUSION CAPACITY WERE RECORDED THRICE IN BOTH THE GROUPS: 0 DAY AS BASELINE, 22(ND) DAY AND ON 90(TH) DAY BY USING COMPUTERIZED MS MEDISOFT CARDIO-RESPIRATORY INSTRUMENT, HYP'AIR COMPACT MODEL OF CARDIO-RESPIRATORY TESTING MACHINE WAS MANUFACTURED BY P K MORGAN, INDIA. THE RECORDED PARAMETERS WERE STATISTICALLY ANALYZED BY REPEATED MEASURES ANOVA FOLLOWED BY TUKEY'S TEST IN BOTH THE GROUPS. CARDIOVASCULAR PARAMETERS WERE ALSO COMPARED BEFORE AND AFTER INTERVENTION IN BOTH THE GROUPS. RESULTS: STATISTICALLY SIGNIFICANT IMPROVEMENTS WERE SEEN IN SLOW VITAL CAPACITY, FORCED VITAL CAPACITY, PEAK EXPIRATORY FLOW RATE, MAXIMUM VOLUNTARY VENTILATION, AND DIFFUSION FACTOR/ TRANSFER FACTOR OF LUNG FOR CARBON MONOXIDE AFTER 3 MONTHS OF YOGA REGIMEN IN GROUP I. FORCED EXPIRATORY VOLUME IN 1(ST) SEC (FEV1), AND FEV1 % ALSO SHOWED A TREND TOWARD IMPROVEMENT ALTHOUGH NOT STATISTICALLY SIGNIFICANT. HR, SBP AND DBP ALSO SHOWED SIGNIFICANT IMPROVEMENT IN GROUP-I PATIENTS WHO FOLLOWED YOGA REGIMEN. CONCLUSIONS: YOGA REGIMEN WAS FOUND TO IMPROVE LUNG FUNCTIONS AND DIFFUSION CAPACITY IN CAD PATIENTS BESIDES IMPROVING CARDIOVASCULAR FUNCTIONS. THUS, IT CAN BE USED AS A COMPLIMENTARY OR ADJUNCT THERAPY ALONG WITH THE CONVENTIONAL MEDICINE FOR THEIR TREATMENT AND REHABILITATION. 2015 6 419 48 BREATHING-FOCUSED YOGA INTERVENTION ON RESPIRATORY DECLINE IN CHRONICALLY PESTICIDE-EXPOSED FARMERS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: OCCUPATIONAL EXPOSURE TO PESTICIDES HAS BEEN ASSOCIATED WITH LUNG AND COGNITIVE FUNCTION EXACERBATIONS. IN THE PRESENT STUDY, WE TESTED THE EFFECTIVENESS OF BREATHING FOCUSED YOGA INTERVENTION ON ALLEVIATION OF ADVERSE RESPIRATORY AND COGNITIVE EFFECTS ASSOCIATED WITH CHRONIC PESTICIDE EXPOSURE IN FARMERS. METHODS: WE UNDERTOOK A PARALLEL, TWO-ARMED RANDOMIZED CONTROLLED TRIAL WITH BLINDED OUTCOME ASSESSORS ON A CHRONICALLY PESTICIDE-EXPOSED FARMING POPULATION. THE STUDY WAS CONDUCTED AT DISTRICT PANIPAT, STATE HARYANA LOCATED IN THE NORTHERN PART OF INDIA FROM NOVEMBER 2019 TO AUGUST 2020. A TOTAL OF 634 FARMERS WERE SCREENED, AND 140 FARMERS WERE RANDOMIZED TO BREATHING-FOCUSED YOGA INTERVENTION (BFY, N = 70) AND WAITLIST CONTROL ARMS (N = 65). BFY WAS DELIVERED WEEKLY IN 45-MIN GROUP SESSIONS OVER 12 WEEKS FOLLOWED BY HOME-BASED PRACTICE. THE PRIMARY OUTCOME WAS THE CHANGE IN SPIROMETRY-BASED MARKERS OF PULMONARY FUNCTION FROM BASELINE EXPRESSED AS RAW VALUES, GLOBAL LUNG INITIATIVE (GLI) PERCENT PREDICTED (PP), AND GLI Z-SCORES AFTER 24 WEEKS OF INTERVENTION. SECONDARY VARIABLES WERE TRAIL MAKING TESTS (TMT A AND B), DIGIT SYMBOL SUBSTITUTION (DSST), AND WHO QUALITY OF LIFE-BREF (WHOQOL-BREF). ANALYSIS WAS BY INTENTION-TO-TREAT. MEDIATION ANALYSIS WAS DONE CONSIDERING OXIDATIVE STRESS MARKERS AS POTENTIAL MEDIATORS. RESULTS: AT THE END OF 6 MONTHS OF INTERVENTION, THE OVERALL FOLLOW-UP IN THE PARTICIPANTS WAS 87.85% (N = 123); 90% (N = 63) IN THE CONTROL GROUP, AND 85.71% IN THE YOGA GROUP (N = 60). THE MEAN AGE OF THE STUDY COHORT (N = 140) WAS 38.75 (SD = 7.50) YEARS. COMPARED WITH THE CONTROL GROUP, AT 24 WEEKS POST-INTERVENTION, THE BFY GROUP HAD SIGNIFICANTLY IMPROVED STATUS OF THE RAW SAND Z SCORES MARKERS OF AIRWAY OBSTRUCTION, AFTER ADJUSTING FOR CONFOUNDERS, FEV1, FVC, FEF25-75 [Z SCORE-ADJUSTED MEAN DIFFERENCES (95% CI); 1.66 (1.10-2.21) 1.88 (1.21-2.55), AND 6.85 (5.12-8.57), RESPECTIVELY. A FRACTION OF FEF25-75 CHANGE (MEDIATION PERCENTAGE 23.95%) WAS EXPLAINED BY GLUTATHIONE AUGMENTATION. THERE WERE ALSO SIGNIFICANT IMPROVEMENTS IN COGNITIVE SCORES OF DSST, TMT-A AND TMT-B, AND WHOQOL-BREF. CONCLUSION: IN CONCLUSION, REGULAR PRACTICE OF BFY COULD IMPROVE THE EXACERBATIONS IN THE MARKERS OF AIRWAY OBSTRUCTION IN CHRONICALLY PESTICIDE-EXPOSED FARMERS AND COGNITIVE VARIABLES. A SIGNIFICANT MEDIATING EFFECT OF GLUTATHIONE AUGMENTATION WAS ALSO OBSERVED CONCERNING THE EFFECT OF THE INTERVENTION ON FEF25-75. THESE FINDINGS PROVIDE AN IMPORTANT PIECE OF BENEFICIAL EVIDENCE OF THE BREATHING-BASED YOGA INTERVENTION THAT NEEDS VALIDATION ACROSS DIFFERENT FARMING ETHNICITIES.CLINICAL TRIAL REGISTRATION:WWW.CLINICALTRIALS.GOV, IDENTIFIER: CTRI/2019/11/021989. 2022 7 185 54 A RANDOMIZED CONTROLLED TRIAL TO STUDY THE EFFECT OF YOGA THERAPY ON CARDIAC FUNCTION AND N TERMINAL PRO BNP IN HEART FAILURE. AIMS: THE PURPOSE OF THIS STUDY WAS TO EVALUATE WHETHER YOGA TRAINING IN ADDITION TO STANDARD MEDICAL THERAPY CAN IMPROVE CARDIAC FUNCTION AND REDUCE N TERMINAL PRO B-TYPE NATRIURETIC PEPTIDE (NT PRO BNP) IN HEART FAILURE (HF). METHODS: 130 PATIENTS WERE RECRUITED AND RANDOMIZED INTO TWO GROUPS: CONTROL GROUP (CG) (N = 65), YOGA GROUP (YG). IN YG, 44 PATIENTS AND IN CG, 48 PATIENTS COMPLETED THE STUDY. CARDIAC FUNCTION USING LEFT VENTRICULAR EJECTION FRACTION (LVEF), MYOCARDIAL PERFORMANCE INDEX (TEI INDEX), AND NT PRO BNP, A BIOMARKER OF HF, WAS ASSESSED AT BASELINE AND AFTER 12 WEEKS. RESULT: IMPROVEMENT IN LVEF, TEI INDEX, AND NT PRO BNP WERE STATISTICALLY SIGNIFICANT IN BOTH THE GROUPS. FURTHERMORE, WHEN THE CHANGES IN BEFORE AND AFTER 12 WEEKS WERE IN PERCENTAGE, LVEF INCREASED 36.88% IN THE YG AND 16.9% IN THE CG, TEI INDEX WAS REDUCED 27.87% IN THE YG AND 2.79% IN THE CG, NT PRO BNP WAS REDUCED 63.75% IN THE YG AND 10.77% IN THE CG. THE BETWEEN GROUP COMPARISONS FROM PRE TO POST 12 WEEKS WERE SIGNIFICANT FOR YG IMPROVEMENTS (LVEF, P < 0.01, TEI INDEX, P < 0.01, NT PRO BNP, P < 0.01). CONCLUSION: THESE RESULTS INDICATE THAT THE ADDITION OF YOGA THERAPY TO STANDARD MEDICAL THERAPY FOR HF PATIENTS HAS A MARKEDLY BETTER EFFECT ON CARDIAC FUNCTION AND REDUCED MYOCARDIAL STRESS MEASURED USING NT PRO BNP IN PATIENTS WITH STABLE HF. 2014 8 2857 38 YOGA-BASED CARDIAC REHABILITATION AFTER ACUTE MYOCARDIAL INFARCTION: A RANDOMIZED TRIAL. BACKGROUND: GIVEN THE SHORTAGE OF CARDIAC REHABILITATION (CR) PROGRAMS IN INDIA AND POOR UPTAKE WORLDWIDE, THERE IS AN URGENT NEED TO FIND ALTERNATIVE MODELS OF CR THAT ARE INEXPENSIVE AND MAY OFFER CHOICE TO SUBGROUPS WITH POOR UPTAKE (E.G., WOMEN AND ELDERLY). OBJECTIVES: THIS STUDY SOUGHT TO EVALUATE THE EFFECTS OF YOGA-BASED CR (YOGA-CARE) ON MAJOR CARDIOVASCULAR EVENTS AND SELF-RATED HEALTH IN A MULTICENTER RANDOMIZED CONTROLLED TRIAL. METHODS: THE TRIAL WAS CONDUCTED IN 24 MEDICAL CENTERS ACROSS INDIA. THIS STUDY RECRUITED 3,959 PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH A MEDIAN AND MINIMUM FOLLOW-UP OF 22 AND 6 MONTHS. PATIENTS WERE INDIVIDUALLY RANDOMIZED TO RECEIVE EITHER A YOGA-CARE PROGRAM (N = 1,970) OR ENHANCED STANDARD CARE INVOLVING EDUCATIONAL ADVICE (N = 1,989). THE CO-PRIMARY OUTCOMES WERE: 1) FIRST OCCURRENCE OF MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE) (COMPOSITE OF ALL-CAUSE MORTALITY, MYOCARDIAL INFARCTION, STROKE, OR EMERGENCY CARDIOVASCULAR HOSPITALIZATION); AND 2) SELF-RATED HEALTH ON THE EUROPEAN QUALITY OF LIFE-5 DIMENSIONS-5 LEVEL VISUAL ANALOGUE SCALE AT 12 WEEKS. RESULTS: MACE OCCURRED IN 131 (6.7%) PATIENTS IN THE YOGA-CARE GROUP AND 146 (7.4%) PATIENTS IN THE ENHANCED STANDARD CARE GROUP (HAZARD RATIO WITH YOGA-CARE: 0.90; 95% CONFIDENCE INTERVAL [CI]: 0.71 TO 1.15; P = 0.41). SELF-RATED HEALTH WAS 77 IN YOGA-CARE AND 75.7 IN THE ENHANCED STANDARD CARE GROUP (BASELINE-ADJUSTED MEAN DIFFERENCE IN FAVOR OF YOGA-CARE: 1.5; 95% CI: 0.5 TO 2.5; P = 0.002). THE YOGA-CARE GROUP HAD GREATER RETURN TO PRE-INFARCT ACTIVITIES, BUT THERE WAS NO DIFFERENCE IN TOBACCO CESSATION OR MEDICATION ADHERENCE BETWEEN THE TREATMENT GROUPS (SECONDARY OUTCOMES). CONCLUSIONS: YOGA-CARE IMPROVED SELF-RATED HEALTH AND RETURN TO PRE-INFARCT ACTIVITIES AFTER ACUTE MYOCARDIAL INFARCTION, BUT THE TRIAL LACKED STATISTICAL POWER TO SHOW A DIFFERENCE IN MACE. YOGA-CARE MAY BE AN OPTION WHEN CONVENTIONAL CR IS UNAVAILABLE OR UNACCEPTABLE TO INDIVIDUALS. (A STUDY ON EFFECTIVENESS OF YOGA BASED CARDIAC REHABILITATION PROGRAMME IN INDIA AND UNITED KINGDOM; CTRI/2012/02/002408). 2020 9 508 29 COMPARATIVE EFFICACY OF A 12 WEEK YOGA-BASED LIFESTYLE INTERVENTION AND DIETARY INTERVENTION ON ADIPOKINES, INFLAMMATION, AND OXIDATIVE STRESS IN ADULTS WITH METABOLIC SYNDROME: A RANDOMIZED CONTROLLED TRIAL. THE PRESENT RANDOMIZED CONTROLLED TRIAL (RCT) EVALUATED THE COMPARATIVE EFFICACY OF 12 WEEK YOGA-BASED LIFESTYLE INTERVENTION (YBLI) AND DIETARY INTERVENTION (DI) ALONE ON ADIPOKINES, INFLAMMATION, AND OXIDATIVE STRESS IN INDIAN ADULTS WITH METABOLIC SYNDROME (MET S). A PARALLEL, TWO ARM, RCT WAS CONDUCTED IN INTEGRAL HEALTH CLINIC (IHC), ALL INDIA INSTITUTE OF MEDICAL SCIENCES, INDIA FROM 2012 TO 2014. IHC IS AN OUTPATIENT FACILITY CONDUCTING YBLI PROGRAMS FOR PREVENTION AND MANAGEMENT OF CHRONIC DISEASES. TWO HUNDRED SIXTY MEN AND WOMEN (20-45 YEARS) VISITING THE OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL WERE DIAGNOSED WITH MET S AND RANDOMIZED 1:1 TO RECEIVE 12 WEEK YBLI (N = 130) OR DI (N = 130). PRIMARY OUTCOMES WERE CHANGE IN PLASMA LEVELS OF ADIPOKINES (LEPTIN, ADIPONECTIN, AND LEPTIN:ADIPONECTIN RATIO), MARKERS OF INFLAMMATION (TUMOR NECROSIS FACTOR [TNF]-ALPHA, INTERLEUKIN [IL]-6), MARKERS OF OXIDATIVE STRESS (THIOBARBITURIC ACID REACTIVE SUBSTANCES [TBARS], 8-HYDROXY-2'-DEOXYGUANOSINE [8-OHDG], AND SUPEROXIDE DISMUTASE [SOD]) MEASURED AT BASELINE, 2 WEEKS, AND 12 WEEKS. YBLI GROUP SHOWED A SIGNIFICANT DECREASE IN LEPTIN, LEPTIN:ADIPONECTIN RATIO, IL-6, 8-OHDG, AND TBARS LEVELS, WHEREAS THERE WAS A SIGNIFICANT INCREASE IN ADIPONECTIN AND SOD LEVELS. NO SIGNIFICANT CHANGES WERE NOTICED IN DI ALONE GROUP. YBLI SHOWED SIGNIFICANTLY GREATER REDUCTION IN TBARS LEVELS THAN IN DI GROUP, SUGGESTIVE OF REDUCED OXIDATIVE STRESS IN ADULTS WITH MET S. A 12 WEEK YBLI HAD A POSITIVE IMPACT ON OXIDATIVE STRESS VERSUS DI ALONE IN ADULTS WITH MET S. 2019 10 1904 43 RETARDATION OF CORONARY ATHEROSCLEROSIS WITH YOGA LIFESTYLE INTERVENTION. BACKGROUND: YOGA HAS POTENTIAL FOR BENEFIT FOR PATIENTS WITH CORONARY ARTERY DISEASE THOUGH OBJECTIVE, ANGIOGRAPHIC STUDIES ARE LACKING. MATERIAL AND METHODS: WE EVALUATED POSSIBLE ROLE OF LIFESTYLE MODIFICATION INCORPORATING YOGA, ON RETARDATION OF CORONARY ATHEROSCLEROTIC DISEASE. IN THIS PROSPECTIVE, RANDOMIZED, CONTROLLED TRIAL, 42 MEN WITH ANGIOGRAPHICALLY PROVEN CORONARY ARTERY DISEASE (CAD) WERE RANDOMIZED TO CONTROL (N = 21) AND YOGA INTERVENTION GROUP (N = 21) AND WERE FOLLOWED FOR ONE YEAR. THE ACTIVE GROUP WAS TREATED WITH A USER-FRIENDLY PROGRAM CONSISTING OF YOGA, CONTROL OF RISK FACTORS, DIET CONTROL AND MODERATE AEROBIC EXERCISE. THE CONTROL GROUP WAS MANAGED BY CONVENTIONAL METHODS I.E. RISK FACTOR CONTROL AND AMERICAN HEART ASSOCIATION STEP I DIET. RESULTS: AT ONE YEAR, THE YOGA GROUPS SHOWED SIGNIFICANT REDUCTION IN NUMBER OF ANGINAL EPISODES PER WEEK, IMPROVED EXERCISE CAPACITY AND DECREASE IN BODY WEIGHT. SERUM TOTAL CHOLESTEROL, LDL CHOLESTEROL AND TRIGLYCERIDE LEVELS ALSO SHOWED GREATER REDUCTIONS AS COMPARED WITH CONTROL GROUP. REVASCULARISATION PROCEDURES (CORONARY ANGIOPLASTY OR BYPASS SURGERY) WERE LESS FREQUENTLY REQUIRED IN THE YOGA GROUP (ONE VERSUS EIGHT PATIENTS; RELATIVE RISK = 5.45; P = 0.01). CORONARY ANGIOGRAPHY REPEATED AT ONE YEAR SHOWED THAT SIGNIFICANTLY MORE LESIONS REGRESSED (20% VERSUS 2%) AND LESS LESIONS PROGRESSED (5% VERSUS 37%) IN THE YOGA GROUP (CHI-SQUARE = 24.9; P < 0.0001). THE COMPLIANCE TO THE TOTAL PROGRAM WAS EXCELLENT AND NO SIDE EFFECTS WERE OBSERVED. CONCLUSION: YOGA LIFESTYLE INTERVENTION RETARDS PROGRESSION AND INCREASES REGRESSION OF CORONARY ATHEROSCLEROSIS IN PATIENTS WITH SEVERE CORONARY ARTERY DISEASE. IT ALSO IMPROVES SYMPTOMATIC STATUS, FUNCTIONAL CLASS AND RISK FACTOR PROFILE. 2000 11 389 49 BENEFITS OF YOGA FOR AFRICAN AMERICAN HEART FAILURE PATIENTS. BACKGROUND: THE NUMBER OF AFRICAN AMERICAN (AA) PATIENTS LIVING WITH HEART FAILURE (HF) HAS BEEN INCREASING, ESPECIALLY AMONG THE ECONOMICALLY DISADVANTAGED. YOGA THERAPY HAS BEEN FOUND TO IMPROVE PHYSICAL AND PSYCHOLOGICAL PARAMETERS AMONG HEALTHY INDIVIDUALS, BUT ITS EFFECT IN PATIENTS WITH HF REMAINS UNKNOWN. THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE EFFECTS OF YOGA THERAPY ON CARDIOVASCULAR ENDURANCE (VO2PEAK), FLEXIBILITY, QUALITY OF LIFE (QOL), AND INFLAMMATORY MARKERS ON MEDICALLY STABLE HF PATIENTS. METHODS: FORTY PATIENTS (38 AA, 1 ASIAN, AND 1 CAUCASIAN) WITH SYSTOLIC OR DIASTOLIC HF WERE RANDOMIZED TO THE YOGA GROUP (YG, N = 21) OR THE CONTROL GROUP (CG, N = 19). ALL PATIENTS WERE ASKED TO FOLLOW A HOME WALK PROGRAM. PREMEASUREMENT AND POSTMEASUREMENT INCLUDED A TREADMILL STRESS TEST TO PEAK EXERTION, FLEXIBILITY, INTERLEUKIN-6 (IL-6), C-REACTIVE PROTEIN (CRP), AND EXTRACELLULAR SUPEROXIDE DISMUTASE (EC-SOD). QOL WAS ASSESSED BY THE MINNESOTA LIVING WITH HEART FAILURE QUESTIONNAIRE (MLWHFQ). RESULTS: THE STATISTICAL ANALYSES (ASSESSED BY ANOVA AND T-TESTS) WERE SIGNIFICANT FOR FAVORABLE CHANGES IN THE YG, COMPARED WITH THOSE IN THE CG, FOR FLEXIBILITY (P = 0.012), TREADMILL TIME (P = 0.002), VO2PEAK (P = 0.003), AND THE BIOMARKERS (IL-6, P = 0.004; CRP, P = 0.016; AND EC-SOD, P = 0.012). WITHIN THE YG, PRETEST TO POSTTEST SCORES FOR THE TOTAL (P = 0.02) AND PHYSICAL SUBSCALES (P < 0.001) OF THE MLWHFQ WERE IMPROVED. CONCLUSIONS: YOGA THERAPY OFFERED ADDITIONAL BENEFITS TO THE STANDARD MEDICAL CARE OF PREDOMINANTLY AA HF PATIENTS BY IMPROVING CARDIOVASCULAR ENDURANCE, QOL, INFLAMMATORY MARKERS, AND FLEXIBILITY. 2010 12 881 43 EFFECT OF YOGA TRAINING ON INFLAMMATORY CYTOKINES AND C-REACTIVE PROTEIN IN EMPLOYEES OF SMALL-SCALE INDUSTRIES. OBJECTIVE: THE PRESENT STUDY INTENDS TO SEE THE EFFECT OF YOGA PRACTICES ON LIPID PROFILE, INTERLEUKIN (IL)-6, TUMOR NECROSIS FACTOR (TNF)-ALPHA, AND HIGH-SENSITIVITY-C-REACTIVE PROTEIN (HS-CRP) AMONG APPARENTLY HEALTHY ADULTS EXPOSED TO OCCUPATIONAL HAZARDS. MATERIALS AND METHODS: IN THE PRESENT STUDY, 48 PARTICIPANTS AGED 30-58 YEARS (41.5 +/- 5.2) WHO WERE EXPOSED TO OCCUPATIONAL HAZARDS WERE RANDOMIZED INTO TWO GROUPS, THAT IS, EXPERIMENTAL AND WAIT-LIST CONTROL. ALL THE PARTICIPANTS WERE ASSESSED FOR LIPID PROFILE, IL-6, TNF-ALPHA, AND HS-CRP AT THE BASELINE AND AFTER COMPLETION OF 3 MONTHS OF YOGA TRAINING INTERVENTION. THE EXPERIMENTAL GROUP UNDERWENT YOGA TRAINING INTERVENTION FOR 1 H FOR 6 DAYS A WEEK FOR 3 MONTHS, WHEREAS CONTROL GROUP CONTINUED WITH THEIR DAILY ACTIVITIES EXCEPT YOGA TRAINING. DATA ANALYSIS WAS DONE USING STATISTICAL SOFTWARE SPSS VERSION 20.0. DATA WERE ANALYZED USING PAIRED T-TESTS AND INDEPENDENT T-TEST. RESULTS: THE RESULTS OF WITHIN GROUP COMPARISON REVEALED HIGHLY SIGNIFICANT CHANGES IN CHOLESTEROL (P < 0.001), HIGH-DENSITY LIPOPROTEIN (P < 0.001), LOW-DENSITY LIPOPROTEIN (LDL)(P < 0.01), HS-CRP (P < 0.01), IL-6 (P < 0.001), AND TNF-ALPHA (P < 0.001) IN EXPERIMENTAL GROUP. COMPARISON BETWEEN EXPERIMENTAL AND CONTROL GROUP REVEALED SIGNIFICANT CHANGES IN CHOLESTEROL (P < 0.01), LDL (P < 0.05), IL-6 (P < 0.01), TNF-ALPHA (P < 0.01), AND HS-CRP (P < 0.01). CONCLUSION: A YOGA-BASED LIFESTYLE INTERVENTION SEEMS TO BE A HIGHLY PROMISING ALTERNATIVE THERAPY WHICH FAVORABLY ALTERS INFLAMMATORY MARKERS AND METABOLIC RISK FACTORS. 2017 13 776 31 EFFECT OF YOGA AND NATUROPATHY-BASED LIFESTYLE MODIFICATION ON LEFT VENTRICULAR EJECTION FRACTION IN A PATIENT WITH SEVERE TRIPLE VESSEL DISEASE: A CASE REPORT. A 75-YEAR-OLD, MARRIED MAN WAS DIAGNOSED WITH CORONARY ARTERY DISEASE (CAD) [SEVERE TRIPLE VESSEL DISEASE (TVD)] IN THE 2(ND) WEEK, JUNE-2018. THE PHYSICIAN ADVISED HIM TO UNDERGO CONVENTIONAL MEDICATION AND CORONARY ARTERY BYPASS GRAFT. SINCE THE PATIENT REFUSED TO UNDERGO SURGERY HE WAS ADMITTED IN OUR HOSPITAL AND UNDERWENT YOGA AND NATUROPATHY-BASED LIFESTYLE MODIFICATION (YNLM) ALONG WITH CONVENTIONAL MEDICINES FOR 16 WEEKS [12 WEEKS OF INTENSIVE CARE AT INPATIENT DEPARTMENT AND 4 WEEKS AT OUTPATIENT DEPARTMENT (OPD)]. AFTER 16 WEEKS, THE PATIENT VISITED OUR OPD ONCE/TWICE A MONTH FOR 6 MONTHS. AN INCREASE IN LEFT VENTRICULAR EJECTION FRACTION FROM 35 TO 48%; AND A REDUCTION IN WEIGHT FROM 77.5 TO 71-KG, AND BMI FROM 26.60 TO 24-KG/M(2) WERE OBSERVED AFTER 6 MONTHS OF FOLLOW-UP COMPARED WITH BASELINE. THUS, YNLM MIGHT BE CONSIDERED AS AN ADJUVANT IN REDUCING RISK FACTOR AND IN IMPROVING LEFT VENTRICULAR SYSTOLIC DYSFUNCTION IN PATIENTS WITH CAD (SEVERE-TVD). HOWEVER, FURTHER STUDIES ARE REQUIRED TO ESTABLISH THE EFFICACY OF YNLM FOR CAD. 2020 14 944 39 EFFECTS OF A 12-WEEK HATHA YOGA INTERVENTION ON METABOLIC RISK AND QUALITY OF LIFE IN HONG KONG CHINESE ADULTS WITH AND WITHOUT METABOLIC SYNDROME. OBJECTIVE: TO DETERMINE THE EFFICACY OF A 12-WEEK HATHA YOGA INTERVENTION TO IMPROVE METABOLIC RISK PROFILES AND HEALTH-RELATED QUALITY OF LIFE (HRQOL) IN CHINESE ADULTS WITH AND WITHOUT METABOLIC SYNDROME (METS). METHODS: WE CONDUCTED A CONTROLLED TRIAL WITHIN AN UNIVERSITY-AFFILIATED HOSPITAL. 173 CHINESE MEN AND WOMEN AGED 18 OR ABOVE WERE ASSIGNED TO EITHER THE YOGA INTERVENTION GROUP (N = 87) OR THE CONTROL GROUP (N = 86). PRIMARY OUTCOMES INCLUDED 12-WEEK CHANGE IN METABOLIC RISK FACTORS AND METS Z SCORE. SECONDARY OUTCOME WAS HRQOL (MEDICAL OUTCOMES SHORT FORM SURVEY AT 12 WEEKS). RESULTS: THE MEAN AGE OF PARTICIPANTS WAS 52.0 (SD 7.4, RANGE 31-71) YEARS. ANALYSIS INVOLVING THE ENTIRE STUDY POPULATION REVEALED THAT THE YOGA GROUP ACHIEVED GREATER DECLINE IN WAIST CIRCUMFERENCE (P<0.001), FASTING GLUCOSE (P<0.01), TRIGLYCERIDES (P<0.05), AND METS Z SCORE (P<0.01). YOGA TRAINING ALSO IMPROVED GENERAL HEALTH PERCEPTIONS (P<0.01), PHYSICAL COMPONENT SCORE (P<0.01), AND SOCIAL FUNCTIONING (P<0.01) DOMAINS SCORE OF HRQOL. HOWEVER, NO SIGNIFICANT DIFFERENCES BETWEEN GROUPS WERE OBSERVED IN THE MEAN CHANGE OF SYSTOLIC/DIASTOLIC BLOOD PRESSURES OR HIGH-DENSITY LIPID PROTEIN CHOLESTEROL (ALL P>0.05). THERE WERE NO SIGNIFICANT DIFFERENCES IN THE INTERVENTION EFFECTS ON WAIST CIRCUMFERENCE AND METS Z SCORE BETWEEN THE METS SUBGROUPS (BOTH P>0.05). CONCLUSION: A 12-WEEK HATHA YOGA INTERVENTION IMPROVES METABOLIC RISK PROFILES AND HRQOL IN CHINESE ADULTS WITH AND WITHOUT METS. TRIAL REGISTRATION: AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY ACTRN12613000816752. 2015 15 1374 35 IMPACT OF AN INTEGRATED YOGA THERAPY PROTOCOL ON INSULIN RESISTANCE AND GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS. OBJECTIVE: DIABETES MELLITUS (DM), CHARACTERIZED BY CHRONIC HYPERGLYCEMIA, IS ATTRIBUTED TO RELATIVE INSULIN DEFICIENCY OR RESISTANCE, OR BOTH. STUDIES HAVE SHOWN THAT YOGA CAN MODULATE PARAMETERS OF INSULIN RESISTANCE. THE PRESENT STUDY EXPLORED THE POSSIBLE BENEFICIAL EFFECTS OF INTEGRATED YOGA THERAPY WITH REFERENCE TO GLYCEMIC CONTROL AND INSULIN RESISTANCE (IR) IN INDIVIDUALS WITH DIABETES MAINTAINED ON STANDARD ORAL MEDICAL CARE WITH YOGA THERAPY, COMPARED TO THOSE ON STANDARD ORAL MEDICAL CARE ALONE. METHODS: IN THIS STUDY, THE SUBJECTS ON YOGA INTERVENTION COMPRISED 35 TYPE 2 DIABETICS, AND AN EQUAL NUMBER OF VOLUNTEERS CONSTITUTED THE CONTROL GROUP. SUBJECTS RANGED IN AGE FROM 30 TO 70 YEARS, WITH HEMOGLOBIN A1C (HBA1C) TEST MORE THAN 7%, AND WERE MAINTAINED ON DIABETIC DIET AND ORAL HYPOGLYCEMIC AGENTS. BLOOD SAMPLES WERE DRAWN PRIOR TO AND AFTER 120 DAYS OF INTEGRATED YOGA THERAPY INTERVENTION. FASTING BLOOD GLUCOSE (FBG), POST-PRANDIAL BLOOD GLUCOSE (PPBG), HBA1C, INSULIN, AND LIPID PROFILE WERE ASSESSED IN BOTH THE INTERVENTION AND CONTROL GROUPS. RESULTS: THE INTERVENTION GROUP REVEALED SIGNIFICANT IMPROVEMENTS IN BODY MASS INDEX (BMI) (0.7 KG/M(2) MEDIAN DECREASE; P=0.001), FBG (20 MG/DL MEDIAN DECREASE; P<0.001), PPBG (33 MG/DL MEDIAN DECREASE; P<0.001), HBA1C (0.4% MEDIAN DECREASE; P<0.001), HOMEOSTATIC MODEL ASSESSMENT FOR INSULIN RESISTANCE (HOMA-IR) (1.2 MEDIAN DECREASE; P<0.001), CHOLESTEROL (13 MG/DL MEDIAN DECREASE, P=0.006), TRIACYLGLYCEROL (22 MG/DL MEDIAN DECREASE; P=0.027), LOW-DENSITY LIPOPROTEIN (6 MG/DL MEDIAN DECREASE; P=0.004), AND VERY-LOW-DENSITY LIPOPROTEIN LEVELS (4 MG/DL MEDIAN DECREASE; P=0.032). INCREASES IN HIGH-DENSITY LIPOPROTEIN AFTER 120 DAYS WERE NOT SIGNIFICANT (6 MG/DL MEDIAN INCREASE; P=0.15). HOWEVER, WHEN COMPARED TO CHANGES OBSERVED IN PATIENTS IN THE CONTROL GROUP, ALL THESE IMPROVEMENTS PROVED TO BE SIGNIFICANT. CONCLUSION: ADMINISTRATION OF INTEGRATED YOGA THERAPY TO INDIVIDUALS WITH DIABETES LEADS TO A SIGNIFICANT IMPROVEMENT IN GLYCEMIC CONTROL, INSULIN RESISTANCE, AND KEY BIOCHEMICAL PARAMETERS. 2022 16 384 41 BENEFICIAL EFFECTS OF YOGA LIFESTYLE ON REVERSIBILITY OF ISCHAEMIC HEART DISEASE: CARING HEART PROJECT OF INTERNATIONAL BOARD OF YOGA. OBJECTIVES: YOGA BASED LIFESTYLE MODIFICATIONS HAVE BEEN EARLIER SHOWN TO BE BENEFICIAL IN CORONARY ARTERY DISEASE IN A SMALL NUMBER OF PATIENTS. WE EVALUATED THE ROLE OF LIFESTYLE MODIFICATION BASED ON YOGA TECHNIQUES, STRESS MANAGEMENT AND DIETARY MODIFICATIONS IN RETARDATION OF CORONARY ARTERY DISEASE. METHODS: THIS PROSPECTIVE, CONTROLLED, OPEN TRIAL INCLUDED ANGIOGRAPHICALLY PROVEN CORONARY ARTERY DISEASE PATIENTS (71 PATIENTS IN STUDY GROUP AND 42 PATIENTS IN CONTROL GROUP). THEY WERE ASSESSED CLINICALLY, BY BIOCHEMICAL PARAMETERS, STRESS MYOCARDIAL PERFUSION AND FUNCTION STUDIES AND CORONARY ANGIOGRAPHY AND ON PSYCHOLOGICAL PARAMETERS. THE STUDY GROUP PATIENTS WERE GIVEN A FAMILY BASED YOGA PROGRAMME WHICH INCLUDED, CONTROL OF RISK FACTORS, DIETARY MODIFICATIONS AND STRESS MANAGEMENT FOR A PERIOD OF ONE YEAR. THE PATIENTS WERE ASSESSED AT BASELINE, AT FREQUENT INTERVALS AND AT THE END OF ONE YEAR. RESULTS: AT THE END OF ONE YEAR OF YOGA TRAINING, STATISTICAL SIGNIFICANT CHANGES (P<0.05) WERE FOUND IN SERUM TOTAL CHOLESTEROL (REDUCTION BY 23.3% IN STUDY GROUP PATIENTS AS COMPARED TO 4.4% IN CONTROLS); SERUM LDL CHOLESTEROL (REDUCTION OF 26% IN STUDY GROUP PATIENTS AS COMPARED TO 2.6% IN THE CONTROL GROUP), REGRESSION OF DISEASE (43.7% OF STUDY GROUP PATIENTS V/S 31% CONTROL GROUP ON MPI AND 70.4% OF STUDY GROUP V/S 28% OF CONTROL GROUP ON ANGIOGRAPHY) ARREST OF PROGRESSION (46.5% STUDY GROUP V/S 33.3% CONTROL GROUP ON MPI) AND PROGRESSION (9.9% OF STUDY GROUP VS 35.7% OF CONTROLS ON MPI, 29.6% OF STUDY GROUP V/S 60.0% OF CONTROLS ON ANGIOGRAPHY). AT THE END OF THE STUDY IMPROVEMENT IN ANXIETY SCORES WAS CONCORDANT WITH THE IMPROVEMENT SEEN IN THE MPI. NO UNTOWARD EFFECTS OF THE THERAPY WERE OBSERVED. CONCLUSION: YOGA BASED LIFESTYLE MODIFICATIONS HELP IN REGRESSION OF CORONARY LESIONS AND IN IMPROVING MYOCARDIAL PERFUSION. THIS IS TRANSLATED INTO CLINICAL BENEFITS AND SYMPTOMATIC IMPROVEMENT. 2004 17 2507 44 YOGA BASED CARDIAC REHABILITATION AFTER CORONARY ARTERY BYPASS SURGERY: ONE-YEAR RESULTS ON LVEF, LIPID PROFILE AND PSYCHOLOGICAL STATES--A RANDOMIZED CONTROLLED STUDY. OBJECTIVE: TO COMPARE THE LONG TERM EFFECTS OF YOGA BASED CARDIAC REHABILITATION PROGRAM WITH ONLY PHYSIOTHERAPY BASED PROGRAM AS AN ADD-ON TO CONVENTIONAL REHABILITATION AFTER CORONARY ARTERY BYPASS GRAFTING (CABG) ON RISK FACTORS. METHODS: IN THIS SINGLE BLIND PROSPECTIVE RANDOMIZED PARALLEL TWO ARMED ACTIVE CONTROL STUDY, 1026 PATIENTS POSTED FOR CABG AT NARAYANA HRUDAYALAYA INSTITUTE OF CARDIAC SCIENCES, BENGALURU (INDIA) WERE SCREENED. OF THESE, 250 MALE PARTICIPANTS (35-65 YEARS) WHO SATISFIED THE SELECTION CRITERIA AND CONSENTED WERE RANDOMIZED INTO TWO GROUPS. WITHIN AND BETWEEN GROUP COMPARISONS WERE DONE AT THREE POINTS OF FOLLOW UP (I.E. 6TH WEEK, 6TH MONTH, AND 12TH MONTH) BY USING WILCOXON'S SIGNED RANKS TEST AND MANN WHITNEY U TEST RESPECTIVELY. RESULTS: YOGA GROUP HAD SIGNIFICANTLY (P = 0.001, MANN WHITNEY) BETTER IMPROVEMENT IN LVEF THAN CONTROL GROUP IN THOSE WITH ABNORMAL BASELINE EF (<53%) AFTER 1 YEAR. THERE WAS A BETTER REDUCTION IN BMI IN THE YOGA GROUP (P = 0.038, BETWEEN GROUPS) IN THOSE WITH HIGH BASELINE BMI (>/=23) AFTER 12 MONTHS. YOGA GROUP SHOWED SIGNIFICANT (P = 0.008, WILCOXON'S) REDUCTION IN BLOOD GLUCOSE AT ONE YEAR IN THOSE WITH HIGH BASELINE FBS >/=110 MG/DL. THERE WAS SIGNIFICANTLY BETTER IMPROVEMENT IN YOGA THAN THE CONTROL GROUP IN HDL (P = 0.003), LDL (P = 0.01) AND VLDL (P = 0.03) IN THOSE WITH ABNORMAL BASELINE VALUES. THERE WAS SIGNIFICANTLY BETTER IMPROVEMENT (P = 0.02, BETWEEN GROUPS) IN POSITIVE AFFECT IN YOGA GROUP. WITHIN YOGA GROUP, THERE WAS SIGNIFICANT DECREASE IN PERCEIVED STRESS (P = 0.001), ANXIETY (P = 0.001), DEPRESSION (P = 0.001), AND NEGATIVE AFFECT (P = 0.03) WHILE IN THE CONTROL GROUP THERE WAS REDUCTION (P = 0.003) ONLY IN SCORES ON ANXIETY. CONCLUSION: ADDITION OF YOGA BASED RELAXATION TO CONVENTIONAL POST-CABG CARDIAC REHABILITATION HELPS IN BETTER MANAGEMENT OF RISK FACTORS IN THOSE WITH ABNORMAL BASELINE VALUES AND MAY HELP IN PREVENTING RECURRENCE. 2014 18 2072 42 THE EFFECT OF A SIX-WEEK PROGRAM OF YOGA AND MEDITATION ON BRACHIAL ARTERY REACTIVITY: DO PSYCHOSOCIAL INTERVENTIONS AFFECT VASCULAR TONE? BACKGROUND: CHRONIC STRESS IS ESTIMATED TO INCREASE THE RISK OF CARDIOVASCULAR (CV) EVENTS TWO-FOLD. ALTHOUGH STRESS REDUCTION HAS BEEN LINKED TO A REDUCTION IN CV EVENTS, LITTLE IS KNOWN REGARDING ITS EXACT MECHANISM OF BENEFIT. HYPOTHESIS: YOGA AND MEDITATION WILL IMPROVE PARAMETERS OF ENDOTHELIAL FUNCTION. METHODS: WE EXAMINED THE EFFECTS OF YOGA AND MEDITATION ON HEMODYNAMIC AND LABORATORY PARAMETERS AS WELL AS ON ENDOTHELIAL FUNCTION IN A 6-WEEK PILOT STUDY. SYSTOLIC AND DIASTOLIC BLOOD PRESSURES, HEART RATE, BODY MASS INDEX (BMI), FASTING GLUCOSE, LIPIDS, HS C-REACTIVE PROTEIN (CRP), AND ENDOTHELIAL FUNCTION (AS ASSESSED BY BRACHIAL ARTERY REACTIVITY) WERE ALL STUDIED AT BASELINE AND AFTER 6 WEEKS OF YOGA PRACTICE. RESULTS: A COURSE IN YOGA AND MEDITATION WAS GIVEN TO THE SUBJECTS FOR 1.5 H THREE TIMES WEEKLY FOR 6 WEEKS AND SUBJECTS WERE INSTRUCTED TO CONTINUE THEIR EFFORTS AT HOME. THIS PROSPECTIVE COHORT STUDY INCLUDED 33 SUBJECTS (MEAN AGE 55 +/- 11 YEARS) BOTH WITH (30%) AND WITHOUT (70%) ESTABLISHED CORONARY ARTERY DISEASE (CAD). THERE WERE SIGNIFICANT REDUCTIONS IN BLOOD PRESSURE, HEART RATE, AND BMI IN THE TOTAL COHORT WITH YOGA. NONE OF THE LABORATORY PARAMETERS CHANGED SIGNIFICANTLY WITH YOGA. FOR THE TOTAL COHORT THERE WAS NO SIGNIFICANT IMPROVEMENT IN ENDOTHELIAL-DEPENDENT VASODILATATION WITH YOGA TRAINING AND MEDITATION COMPARED WITH BASELINE (16.7% RELATIVE IMPROVEMENT FROM 7.2-8.4%; P = 0.3). IN THE GROUP WITH CAD, ENDOTHELIAL-DEPENDENT VASODILATATION IMPROVED 69% WITH YOGA TRAINING (6.38-10.78%; P = 0.09). CONCLUSION: YOGA AND MEDITATION APPEAR TO IMPROVE ENDOTHELIAL FUNCTION IN SUBJECTS WITH CAD. 2006 19 1066 53 EFFECTS OF YOGA ON INFLAMMATION AND EXERCISE CAPACITY IN PATIENTS WITH CHRONIC HEART FAILURE. BACKGROUND: DESPITE RECENT ADVANCES IN PHARMACOLOGIC AND DEVICE THERAPY, MORBIDITY AND MORTALITY FROM HEART FAILURE (HF) REMAIN HIGH. YOGA COMBINES PHYSICAL AND BREATHING EXERCISES THAT MAY BENEFIT PATIENTS WITH HF. WE HYPOTHESIZED THAT AN 8-WEEK REGIMEN OF YOGA IN ADDITION TO STANDARD MEDICAL THERAPY WOULD IMPROVE EXERCISE CAPACITY, INFLAMMATORY MARKERS, AND QUALITY OF LIFE (QOL) IN PATIENTS WITH HF. METHODS AND RESULTS: NEW YORK HEART ASSOCIATION CLASS I-III HF PATIENTS WERE RANDOMIZED TO YOGA TREATMENT (YT) OR STANDARD MEDICAL THERAPY (MT). MEASUREMENTS INCLUDED A GRADED EXERCISE TEST (GXT) TO V O(2PEAK) AND THE FOLLOWING SERUM BIOMARKERS: INTERLEUKIN-6 (IL-6), HIGH-SENSITIVITY C-REACTIVE PROTEIN (HSCRP), AND EXTRACELLULAR SUPEROXIDE DISMUTASE (EC-SOD). THE MINNESOTA LIVING WITH HEART FAILURE QUESTIONNAIRE (MLHFQ) WAS ADMINISTERED TO ASSESS CHANGES IN QOL. A TOTAL OF 19 PATIENTS WERE ENROLLED AFTER THE INITIAL SCREENING. OF THE 19 PATIENTS, 9 WERE RANDOMIZED TO YT AND 10 TO MT. PATIENTS HAD A MEAN EF OF 25%. GXT TIME AND V O(2PEAK) WERE SIGNIFICANTLY IMPROVED IN THE YT VERSUS MT GROUPS (+18% IN THE YT AND -7.5% IN MT; P = .03 VS. CONTROL AND +17 IN YT AND -7.1 IN MT; P = .02, RESPECTIVELY). THERE WERE STATISTICALLY SIGNIFICANT REDUCTIONS IN SERUM LEVELS OF IL-6 AND HSCRP AND AN INCREASE IN EC-SOD IN THE YT GROUP (ALL P < .005 VS. MT). MLHFQ SCORES IMPROVED BY 25.7% IN THE YT GROUP AND BY 2.9% IN THE MT GROUP. CONCLUSIONS: YOGA IMPROVED EXERCISE TOLERANCE AND POSITIVELY AFFECTED LEVELS OF INFLAMMATORY MARKERS IN PATIENTS WITH HF, AND THERE WAS ALSO A TREND TOWARD IMPROVEMENTS IN QOL. 2008 20 2858 36 YOGA-BASED CARDIAC REHABILITATION: CURRENT PERSPECTIVES FROM RANDOMIZED CONTROLLED TRIALS IN CORONARY ARTERY DISEASE. CORONARY ARTERY DISEASE CARRIES A HIGH MORBIDITY AND MORTALITY WORLDWIDE, AND EXERCISE-BASED CARDIAC REHABILITATION PROGRAMMES PLAY A LARGE ROLE IN SECONDARY PREVENTION. EXERCISE-BASED REHABILITATION PROGRAMMES ARE EXPENSIVE, AND IN CERTAIN SUBGROUPS UPTAKE IS POOR. YOGA HAS BEEN SUGGESTED TO SHOW IMPROVEMENTS IN CARDIOVASCULAR HEALTH WHICH WOULD SUPPORT ITS USE IN CARDIAC REHABILITATION PROGRAMMES. WE CARRIED OUT A REVIEW OF CURRENT RANDOMIZED CONTROLLED TRIALS TO DETERMINE IF YOGA-BASED CARDIAC REHABILITATION LEADS TO REDUCED CARDIAC RISK FACTORS, AND IMPROVED PHYSIOLOGICAL AND PSYCHOLOGICAL OUTCOMES IN PATIENTS WITH CORONARY ARTERY DISEASE COMPARED TO STANDARD CARE. SIX RANDOMIZED CONTROLLED STUDIES WERE IDENTIFIED AFTER A MEDICAL DATABASE SEARCH, AND META-ANALYSIS WAS CARRIED OUT FOR THE DIFFERENT OUTCOMES. OVERALL, THE ADDITION OF YOGA TO STANDARD CARE RESULTED IN IMPROVED SUBJECTIVE FEELING OF CARDIAC HEALTH AND QUALITY OF LIFE. THERE WAS ALSO A TREND TOWARDS IMPROVEMENT IN LEFT VENTRICULAR SYSTOLIC FUNCTION. IMPROVEMENT IN CARDIAC RISK FACTORS, MACE AND PSYCHOLOGICAL HEALTH IN THIS COHORT HAS STILL TO BE PROVEN, BUT WAS NOT INFERIOR TO STANDARD OR ENHANCED CARE, AND THE BENEFITS BECAME MORE PRONOUNCED AT LONGER FOLLOW-UP. FUTURE STUDIES WITH LONGER FOLLOW-UP AND LARGER PATIENT NUMBERS WOULD AID IN ACCURATELY ASSESSING THE LONG-TERM BENEFIT OF YOGA-BASED REHABILITATION. 2021