Potential benefits of yoga in patients with heart failure: A meta-analysis of controlled trials

Introduction: Heart failure (HF) is characterized by breathlessness and reduced exercise tolerance. In addition to drug treatment, guidelines recommend exercise training for HF patients. Since yoga combines breathing and physical exercises and apparently shows positive cardiovascular effects in healthy volunteers, the aim of this meta-analysis was to identify potential benefits of yoga in HF patients. Methods: A systematic literature search in Pubmed and Cochrane Central Register of Controlled Trials was performed. Outcome measures in this meta-analysis were changes in maximum oxygen uptake (VO2 peak), blood pressure, high sensitive C reactive protein (hs-CRP), 6-minutes walking distance (6-MWD), and quality of life (QoL). Results: Five studies with 206 patients were included into the meta-analysis. Yoga therapy resulted in a significantly stronger decrease of hs-CRP compared to control with a mean difference (MD) of -0.39 mg/L [95% CI: -0.54, -0.24; n = 89]. In addition, oxygen uptake (VO2 peak) was statistically significantly increased in the yoga group compared to control group (MD: 3.95 mL/kg/min [95% CI: 2.14, 5.77; n = 59]). The other outcomes, reduction in blood pressure, improvement in 6-MWD and QoL, did not show any statistically significant differences between yoga and control group. Conclusion: In patients with heart failure, yoga indicated a positive effect and could be considered as complementary approach to drug treatment. However, larger randomized controlled trials with longer follow up periods and standardized endpoints are needed to provide definite conclusions