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 pranayama 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.