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A recent study investigated the long-term effects of yoga therapy as a supplementary treatment for managing heart failure. Heart failure, a form of cardiovascular disease, occurs when the heart muscle is either too weak or too rigid to efficiently pump blood, resulting in fluid retention, breathlessness, and other challenges. The severity of a patient’s symptoms is commonly assessed using the New York Heart Association (NYHA) Functional classification system, which categorizes patients into four groups based on their physical activity limitations, with Class I indicating the mildest and Class IV the most severe. Clinicians also measure ejection fraction to evaluate how effectively the heart pumps blood.
The study involved 75 heart failure patients who had undergone coronary intervention, revascularization, or device therapy within the previous six months to one year at a tertiary care center in South India. These patients were all at NYHA Class III or below and had been on optimized medical therapy for a minimum of six months to one year. To be eligible for the trial, patients had to be between 30 and 70 years old and have a left ventricular ejection fraction (LVEF) of 45 percent.
The interventional group consisted of 35 participants (31 males and 4 females), while the non-interventional group had 40 participants (30 males and 10 females). The interventional group received both yoga therapy and standard guideline-directed medical care, while the non-interventional group only received standard guideline-directed medical therapy. To assess the impact of yoga therapy on heart failure patients, echocardiographic parameters were evaluated at various follow-up points.
Ajit Singh, PhD, a research scientist for the Indian Council for Medical Research at Kasturba Medical College & Hospital, Manipal Academy of Heart Education in Manipal, India, and the lead author of the study, explained, “Yoga is a combination of mind-body techniques, which includes a set of physical exercises [asana] combined with breathing techniques [pranayama], relaxation, and meditation that can effectively promote physical and mental well-being. Our patients experienced improvements in systolic blood pressure and heart rate compared to those who were solely on medication.”
Participants in the yoga group were taken to the hospital’s Department of Yoga, where an experienced yoga therapist instructed them in selected yoga practices like pranayama, meditation, and relaxation techniques. Each session lasted approximately 60 minutes, and participants were supervised for one week at the training center before being encouraged to continue self-administered yoga at home.
The yoga group was advised to practice yoga at least five days a week for 12 months. While all participants were taught together to perform the same steps at the training center, individual support was available. Researchers utilized the World Health Organization Quality of Life questionnaire, consisting of 26 questions evaluating physical, psychological, social, and environmental health aspects, to measure improvements in quality of life. Participants completed the questionnaire upon enrollment, as well as at 24 and 48 weeks of follow-up.
The study indicated that participants in the yoga group experienced enhancements in endurance, strength, balance, symptom stability, and overall quality of life. However, there was no improvement observed in social and environmental health, despite physical and psychological improvements.
Echocardiographic parameters did not display significant differences between the two groups at the outset. However, at both the six- and 12-month follow-ups, the interventional (yoga) group demonstrated improved biventricular systolic function compared to the non-interventional group. The interventional group also exhibited substantial progress in functional outcomes, as assessed by the NYHA classification.
Singh emphasized, “This study demonstrates that incorporating yoga therapy alongside standard medical management of heart failure results in an enhancement of left ventricular systolic function and overall quality of life in heart failure patients. Therefore, yoga therapy may contribute to the improvement of physical well-being and left ventricular function in heart failure patients receiving guideline-directed optimal medical therapy.”
