Yôga and Breathing Techniques Training in Patients With Heart Failure and Preserved Ejection Fraction
Condition: Cardiovascular Diseases; Heart Failure; Heart Failure, Diastolic
MeSH terms: Heart Failure; Cardiovascular Diseases; Heart Failure, Diastolic
Study type: Interventional

Summary: 
      Current therapies for heart failure (HF) bring together strategies to improve quality of life
      and exercise tolerance, as well as to reduce 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, maximum oxygen consumption (VO2), functional capacity, respiratory responses to
      exercise, and quality of life. Yoga therapies have been shown to improve quality of life,
      inflammatory markers, and VO2 peak in HF patients, mostly with reduced ejection fraction
      (HFrEF). However, the effect of different yoga breathing techniques in patients with HF with
      preserved ejection fraction (HFpEF) has yet to be assessed.
    

Detailed description: 
      Yôga techniques without breathing control have shown to improve oxygen consumption in
      patients with HF, mostly HFrEF. However, almost half of HF patients present with HFpEF, and
      less studies have been performed in those patients. It has been recently demonstrated that
      HFpEF induces significant molecular, mitochondrial, histological, and functional alterations
      in the diaphragm and soleus, which were attenuated by exercise training . In cardiac disease
      and aging, several authors have shown a significant reduction in heart rate variability (HRV)
      in the frequency ranges associated with breathing, by using spectral analysis of heart rate
      (HR) and respiration.Therefore, the present randomized clinical trial (RCT) will be conducted
      in order to test the hypothesis that an program of yôga and specific breathing techniques
      with different ventilatory rhythms could be associated with improvement in inspiratory muscle
      responses, functional capacity, oxygen uptake efficiency slope (OUES), circulatory power,
      oscillatory ventilation, kinetics of oxygen consumption in the recovery period, distinct
      features of the autonomic nervous system, natriuretic peptides, echocardiographic
      measurements, and quality of life (QoL) in patients with HFpEF, with and without inspiratory
      muscle weakness (IMW).Therefore, the present randomized clinical trial (RCT) will be
      conducted in order to test the hypothesis that an 8-week program of yôga and specific
      breathing techniques with different ventilatory rhythms could be associated with improvement
      in inspiratory muscle responses, functional capacity, oxygen uptake efficiency slope (OUES),
      circulatory power, oscillatory ventilation, kinetics of oxygen consumption in the recovery
      period, distinct features of the autonomic nervous system, natriuretic peptides,
      echocardiographic measurements, and quality of life in patients with HFpEF, with and without
      IMW.
    

Intervention name(s): Yôga; Breathing technique; Control group
Intervention type(s): Other; Other; Other
Intervention description(s): Intervention observing respiratory frequency (RF) of 15- 20 respiratory cycles per minute (rcpm). A standardized 7-minute final relaxation .; Intervention uses diaphragmatic breathing, observing slow respiratory frequency, between 5-8 rcpm. A standardized 7-minute final relaxation.; Patients will be oriented to keep their pharmacological routine and daily activities, with no structured exercises. They will have to return to the hospital for post-testing after 8 weeks from randomization
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Health Services Research
Keywords: Yôga; Breathing Techniques; Heart Failure and Preserved Ejection Fraction