Yoga Therapy Improves Markers of Inflammation and Overall Weil-Being in Patients with Chronic Heart Failure

Abstract

BACKGROUND: Pro-inflammatory markers are associated with unfavorable cardiovascular outcomes in chronic heart failure (CHF). Despite widespread use of effective pharmacological agents, the morbidity of patients with CHF remains high. Yoga therapy (exercise and breathing practices) in CHF may improve the well-being of these patients and retard the pathogenic mechanisms observed in CHF. METHODS: To test the hypothesis that yoga therapy improves quality of life and levels of inflammatory markers in CHF, we followed 12 patients with New York Heart Association Class II or III symptoms of heart failure. Patients were managed on appropriate medical therapy, for at least six months. Half the patients were randomized to the yoga treatment and half were randomized to usual medical care which included a home walk progression. The yoga group attended two 75 minute classes per week for an 8 week period. Measured variables included blood pressure, flexibility, waist/hip ratio, a ramp protocol treadmill test to peak exertion, and serum markers associated with the prognosis of HF, including interleukin-6 (IL-6), C-reactive protein, and extracellular superoxide dismutase (EC-SOD). The Minnesota Living with Heart Failure Questionnaire (MLHF) was also administered. RESULTS: Statistical analysis (SPSS-12, Non-parametric Mann-Whitney U-Test) found that levels of IL-6 and EC-SOD decreased significantly in the yoga intervention (p<0.001 and p<0.02, respectively), but not in the control group. The MLHF scores decreased by one standard deviation in five of the yoga treatment patients (n=6) after completion of the study. All yoga group participants tolerated the yoga intervention without complication and reported an improved ability to perform activities of daily living. This was congruent with the significant improvement in treadmill test time to peak exertion (p=.028) found in the treatment group. CONCLUSIONS: Yoga therapy appears safe to implement and improves quality of life in patients with chronic heart failure. Furthermore, it may provide a beneficial cardiovascular response to exercise and improves levels of inflammatory markers associated with adverse cardiovascular events.