WELL BEING IN HEART FAILURE PATIENTS PRACTICING TAI CHI

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. AIM 1. To determine the relative effects of the Tai Chi intervention, walking exercise program and health- education in older adults with congestive heart failure at 12 and 24 weeks post-intervention on well-being: (a) mood, Beck Depression Inventory (BDI) (b) health related quality of life, Kansas City Cardiomyopathy Questionnaire (KCCQ) and (c) fatigue, Fatigue Severity Scale. Hypothesis 1.A. Participants with congestive heart failure randomized to the Tai Chi group will show significant increases in well-being, including greater reductions in depressed mood and hopelessness, increases in quality of life and decreases in fatigue 12 and 24 weeks post-intervention relative to participants randomized to walking exercise or medical education groups. Hypothesis 1.B. Participants with congestive heart failure randomized to the exercise group will show significant increases in well-being, including greater reductions in depressed mood, hopelessness, increases in quality of life and decreases in fatigue 12 and 24 weeks post-intervention relative to participants randomized into the medical education group. AIM 2. To determine the relative effects of Tai Chi training, walking exercise program and health-education on cytokines (TNF, IL-6, IFN, IL-10) and stress hormone (norepinephrine, epinephrine and cortisol) profiles in older adults with congestive heart failure, at 12 and 24 weeks post-intervention. Hypothesis 2.A. Participants with congestive heart failure randomized to the Tai Chi group will show significant reductions in proinflammatory cytokines, TNF and IL-6 and increases in the Th1/Th2 ratio (IFN /IL-10) 12 and 24 weeks after intervention relative to participants randomized to walking exercise and health-education groups. Hypothesis 2.B. Participants with congestive heart failure randomized to the walking exercise group will show significantly greater reductions in proinflammatory cytokines, TNF and IL-6 and increases in the Th1/Th2 ratio (IFN/IL-10) 12 and 24 weeks after intervention relative to the participants randomized to the health-education group. Hypothesis 2.C. The relationship between condition assignment and quality of life will be mediated by reductions in proinflammatory cytokines, TNF and IL-6 and increases in IFN /IL-10 ratios. AIM 3. To determine the relative effect of Tai Chi practice, walking exercise and health education on secondary outcomes, BNP, and six minute walk test 12 and 24 weeks post-intervention in patients with congestive heart failure. Hypothesis 3. Participants with congestive heart failure randomized to the Tai Chi group will show significant reductions in BNP levels and increases in distance walked in the six minute walk test at 12 and 24 weeks post-intervention.