Abstract
Patients with congestive heart failure (CHF) are limited in their daily lives by symptoms of dyspnea and fatigue. These symptoms result from central and peripheral effects of the failing heart. Additionally, a psychological component may also contribute to the multifactorial perceptions of dyspnea and fatigue. Although some meta-analyses point to an inconsistent impact on objective end points, 1 Spiegel D, Moore R. Imagery and hypnosis in the treatment of cancer patients. Oncology 1997;11:1179–1178. Google Scholar , 2 Wallace K.G Analysis of recent literature concerning relaxation and imagery interventions for cancer pain. Cancer Nursing. 1997; 20: 79-87 Crossref PubMed Scopus (52) Google Scholar studies on mind-body techniques such as hypnosis, 3 Ashton Jr, C Whitworth G.C Seldomridge J.A Shapiro P.A Weinberg A.D Michler R.E Smith C.R Rose E.A Fisher S Oz M.C Self-hypnosis reduces anxiety following coronary artery bypass surgery. A prospective, randomized trial. J Cardiovasc Surg. 1997; 38: 69-75 PubMed Google Scholar biofeedback, meditation, 4 Schneider R.H Staggers F Alexander C.N Sheppard W Rainforth M Kondwani K Smith S King C.G A randomized controlled trial of stress reduction for hypertension in older African Americans. Hypertension. 1995; 26: 820-827 Crossref PubMed Scopus (256) Google Scholar and guided imagery 5 Tusek D Church J.M Fazio V.W Guided imagery as a coping strategy for perioperative patients. Ann RN J. 1997; 66: 644-649 Google Scholar , 6 Troesch L.M Rodehaver C Delaney E Yanes B The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncol Forum. 1993; 20: 1179-1185 PubMed Google Scholar , 7 Maguire B.L The effects of imagery on attitudes and moods in multiple sclerosis patients. Alternative Therap Health Med. 1996; 2: 75-79 PubMed Google Scholar have demonstrated that many subjects have the ability to effect physiological and psychological changes upon themselves. Mind-body techniques that invoke the relaxation response have been shown to reduce resting metabolic rates, improve hemodynamics, and decrease stress and anxiety in healthy and ill populations. 8 Wallace R.K Benson H Wilson A.F A wakeful hypometabolic state. Am J Phys. 1971; 3: 795-799 Google Scholar , 9 Benson H Malhoutra M Goldman R Jacobs G Hopkins P Three case reports of the metabolic and electroencephalographic changes during advance Buddhist meditation techniques. Behav Med. 1990; 16: 90-95 Crossref PubMed Scopus (84) Google Scholar , 10 Ornish D Scherwitz L.W Doody R.S et al. Effect of stress management training and dietary changes in treating ischemic heart disease. JAMA. 1983; 249: 54-59 Crossref PubMed Scopus (164) Google Scholar Guided imagery has not been studied in patients with CHF. The effects of this intervention on exercise performance and the sensations of dyspnea and fatigue in patients with severe heart failure were studied before and after instruction of this relaxation technique.
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