Tai Chi May Help Heart Failure Patients

The ancient Chinese exercise of Tai chi may improve quality of life for people suffering from heart failure.

Tai chi combines flowing circular movements, balance and weight-shifting, breathing techniques and focused internal awareness. It has already been shown to be helpful with a number of medical conditions, including hypertension (high blood pressure), balance and musculoskeletal diseases, and fibromyalgia, the researchers noted.

"Tai chi training improved important parameters of quality of life, mood and confidence to perform exercise in patients with heart failure," said lead researcher Dr. Gloria Yeh, from the division of general medicine and primary care at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School.

"Maintaining an exercise regimen is important in heart failure, and Tai chi may be a suitable alternative or adjunct exercise for these patients," she said.

Tai chi incorporates low/moderate intensity aerobics with strength training, breathing techniques, relaxation and stress management, Yeh explained.

The report was published in the April 25 issue of the Archives of Internal Medicine.

For the study, Yeh's team randomly assigned 100 heart failure patients to a 12-week Tai chi program or to educational sessions about heart failure.

The researchers found that although both groups had similar oxygen use during six-minute walks, those who practiced Tai chi showed greater improvements in quality of life, which was measured using the Minnesota Living with Heart Failure Questionnaire.

In addition, those taking part in Tai chi also showed improvement in mood and improvement in the number of calories burned each week, compared with those in the education program, the researchers added.

People with chronic heart failure suffer from the inability of the heart to pump blood efficiently to meet the body's needs. The condition causes shortness of breath, coughing, chronic venous congestion, ankle swelling and difficulty exercising.

Dr. Gregg Fonarow, associate chief of cardiology at David Geffen School of Medicine at University of California Los Angeles, noted that "heart failure results in substantial impairment in functional capacity, quality of life and mood."

"While traditional aerobic exercise may provide some benefits to patients with heart failure, many heart failure patients have difficulty in engaging and sustaining regular aerobic exercise," he added.

There has been increasing interest in using mind-body exercises such as Tai chi for patients with heart failure, Fonarow said. "It may be more easily implemented, pleasant and have the additional benefit of meditation," he added.

"As a complement to standard medical care, this study has demonstrated that Tai chi enhanced quality of life, mood and exercise self-efficacy," Fonarow said. "Tai chi appears to be a safe alternative to low- to moderate-intensity conventional exercise training in patients with heart failure. Further studies are needed to compare Tai chi to aerobic exercise training, and to determine if participation in Tai chi will have a favorable impact on risk of hospitalization or survival in patients with heart failure."

Another study in the same journal found that HIV patients may be at greater risk of developing heart failure.

In the study, Dr. Adeel A. Butt, from the University of Pittsburgh School of Medicine, and colleagues collected data on 8,486 veterans, 2,391 of whom were HIV-positive. Over 7.3 years of follow-up, the researchers found those who were HIV-positive had an 81 percent greater risk of developing heart failure than those who were not HIV-positive.

There could be several reasons for the connection between HIV and heart failure, including the infection itself, heavy alcohol use, side effects of antiretroviral therapy, nutritional deficiencies and damage to the heart muscle, Butt's group speculated.

"HIV infection is associated with an increased risk of heart failure after adjusting for traditional risk factors for heart failure," the researchers wrote. "This association persisted even after exclusion of patients with a baseline history of coronary heart disease, heart failure and angina, as well as a coronary heart disease event in the follow-up period prior to the diagnosis of heart failure and a history of alcohol abuse or dependence diagnosis. Ongoing viral replication is associated with a higher risk of heart failure."