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Rhythmia Breath

Does yoga with breathing exercises improve outcomes after STEMI?

Yoga has finally been proven by scientific research to improve clinical outcomes after myocardial infarction, to decrease symptoms in heart failure and improve quality of life.

The following abstract was presented in the last European Society of Cardiology Congress, August 2019, and was chosen the ‘Abstract of the day’!


ESC Congress News 2019 – Paris, France

Percutaneous coronary intervention (PCI) is widely used to manage ST-elevated myocardial infarction (STEMI) but the relationship between post-procedure left ventricular ejection fraction (LVEF) and mortality is unclear. Results of a study being presented today by Professor Naresh Sen (HG SMS Hospital, Jaipur, India) will report that LVEF is inversely associated with mortality and that yoga with pranayama (breathing exercises) can actually improve LVEF and reduce mortality rates (Abstract P630).

In this study, 2,470 patients receiving PCI for STEMI at three centres in India were randomised to either post-procedure yoga and pranayam or no further intervention. “Patients in the yoga arm undertook three months of a new daily one-hour programme specifically designed for cardiac patients, incorporating yoga and meditation in the morning and a pattern of breathing exercises, comprising slow- and fast-breathing elements, in the evening,” says Prof. Sen.

Although improvement of LVEF (≤34%, 35–45%, 46–54% and ≥55%) was associated with significant reductions in 5-year mortality rates in both the yoga and the non-yoga arms (p<0.004, each), mortality rates in the yoga arm (21.0%, 14.3%, 12.2% and 11.0%, respectively) were consistently lower across categories than those in the non-yoga arm (25.0%, 17.5%, 14.4% and 13.0%, respectively).


Yoga and pranayam led to a 7% increase in LVEF vs no yoga and pranayam (11% vs 4%).

The benefits of yoga and pranayam remained after adjustment for baseline patient characteristics. “Potential explanations for the beneficial effects of yoga and breathing may include reductions in the pressure in the pulmonary and coronary circulation, reduced remodelling of the left ventricle, improved oxygen tension of the blood and also reduced endothelial damage of coronary vessels with decreased release of inflammatory mediators, such as interleukins and C-reactive protein,” says Prof. Sen.

The results of the study show that low LVEF remains an important risk factor post-STEMI but that a daily regimen of yoga and breathing exercises may help to improve LVEF and reduce mortality.