Mind-Body Exercise in the Management of Cardiac Disease

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DESCRIPTION (provided by applicant): Dr. Gloria Yeh's long-term career goal is to become an independent clinician investigator focusing on the critical evaluation, mechanistic understanding, and successful integration of evidence-based complementary and alternative medical (CAM) therapies for patients with cardiovascular disease and heart failure. Her immediate career objectives are: to enhance her methodological skills in clinical trial design and health services research through coursework, educational seminars, and the development of three rigorous, mentored studies; to understand the potential psychosocial and physiological mechanisms by which mind-body exercise can improve clinical outcome in cardiac patients; and to define the potential role of mind-body exercise and other CAM modalities in the current management of patients with cardiovascular disease. This proposal includes three projects with a particular focus on mind-body exercise in patients with chronic heart failure. The first will be a secondary database analysis describing the patterns and prevalence of CAM use in a large national sample of patients with cardiac disease and examining the factors associated with perceived beneficial use of tai chi, qigong, or yoga. The second and main project will be a pilot randomized controlled trial (n=20) evaluating study feasibility and safety of a 12-week tai chi/qigong program in older patients with diastolic heart failure. This study will provide important preliminary data regarding potential psychosocial effects (e.g., change in self-efficacy, mood, quality-of-life) and physiological mechanisms (e.g., change in exercise capacity, autonomic tone, neurohormone status) in preparation for a future R01application for a larger randomized clinical trial. The third project will assess current cardiac rehabilitation programs available to patients with cardiovascular disease and heart failure to begin to explore the incorporation of mind-body exercise into these rehabilitation programs and to understand the perceived successful psychosocial program components (e.g., factors that can enhance patient self-efficacy and program adherence). Completion of the proposed research and career development activities will enhance Dr. Yeh's ability to conduct patient-oriented research and allow her to achieve her career goal of becoming an independent clinical researcher investigating CAM therapies and its applications to patients with cardiac disease.