Key result
Yoga added to usual cardiac rehabilitation fails to improve E/e' over standard care alone.
Why the study?
To determine the effects of yoga practice on subclinical cardiovascular measures, risk factors, and neuro-endocrine pathways in patients undergoing cardiac rehabilitation after acute coronary events.
Does a 12-week yoga intervention added to usual cardiac rehabilitation improve cardiovascular function and exercise capacity in patients following an acute coronary event?
RCT (n=80)
Single-blind
Stratified randomization
Yes
Does a 12-week yoga intervention added to usual cardiac rehabilitation improve cardiovascular function and exercise capacity in patients following an acute coronary event?
The addition of a 12-week yoga intervention to standard cardiac rehabilitation did not significantly improve subclinical cardiovascular or neuroendocrine measures in patients recovering from an acute coronary event.
Answers are grounded in this paper and cite their sources.
Yoga adds no benefit on primary diastolic measure in post-ACS rehab; challenges prior mechanistic evidence.
OBJECTIVE: To determine the effects of yoga practice on subclinical cardiovascular measures, risk factors and neuro-endocrine pathways in patients undergoing cardiac rehabilitation (CR) following acute coronary events. DESIGN: 3-month, two-arm (yoga +usual care vs usual care alone) parallel randomised mechanistic study. SETTING: One general hospital and two primary care CR centres in London. Assessments were conducted at Imperial College London. PARTICIPANTS: 80 participants, aged 35-80 years (68% men, 60% South Asian) referred to CR programmes 2012-2014. INTERVENTION: A certified yoga teacher conducted yoga classes which included exercises in stretching, breathing, healing imagery and deep relaxation. It was pre-specified that at least 18 yoga classes were attended for inclusion in analysis. Participants and partners in both groups were invited to attend weekly a 6- to 12-week local standard UK National Health Service CR programme. MAIN OUTCOME MEASURES: following a 3 min step-test. Effects on the hypothalamus-pituitary-adrenal axis, autonomic function, body fat, blood lipids and glucose, stress and general health were also explored. RESULTS: 25 participants in the yoga + usual care group and 35 participants in the usual care group completed the study. Following the 3-month intervention period, E/e' was not improved by yoga (E/e': between-group difference: yoga minus usual care:-0.40 (-1.38, 0.58). Exercise testing and secondary outcomes also showed no benefits of yoga. CONCLUSIONS: In this small UK-based randomised mechanistic study, with 60 completing participants (of whom 25 were in the yoga + usual care group), we found no discernible improvement associated with the addition of a structured 3-month yoga intervention to usual CR care in key cardiovascular and neuroendocrine measures shown to be responsive to yoga in previous mechanistic studies. TRIAL REGISTRATION NUMBER: NCT01597960; Pre-results.
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Tillin et al. (2019) conducted an RCT in Acute coronary events (n=80). Yoga vs. Usual care alone (standard cardiac rehabilitation) was evaluated on Ratio of early filling and early myocardial velocity (E/e') (MD -0.40, 95% CI -1.38 to 0.58, p=0.4). A 3-month yoga intervention added to usual cardiac rehabilitation care did not improve the primary cardiovascular measure of E/e' compared to usual care alone.
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