Mind-Body Exercise in the Management of Cardiac Disease

描述（由申请人提供）：格洛丽亚叶博士的长期职业目标是成为一名独立的临床研究者，专注于心血管疾病和心力衰竭患者的关键评估，机制理解和循证补充和替代医学（CAM）治疗的成功整合。她的近期职业目标是：通过课程，教育研讨会和三项严格的指导研究的发展，提高她在临床试验设计和卫生服务研究中的方法技能;了解身心锻炼可以改善心脏病患者临床结果的潜在心理和生理机制;并确定身心锻炼和其他CAM模式在心血管疾病患者当前管理中的潜在作用。 该提案包括三个项目，特别关注慢性心力衰竭患者的身心锻炼。第一个将是一个二级数据库分析，描述在全国大样本心脏病患者中使用CAM的模式和流行率，并检查与太极拳，气功或瑜伽的有益使用相关的因素。第二个也是主要项目将是一项试点随机对照试验（n=20），评估12周太极/气功计划在舒张性心力衰竭老年患者中的研究可行性和安全性。这项研究将提供有关潜在心理社会影响的重要初步数据（例如，自我效能、情绪、生活质量的变化）和生理机制（例如，运动能力、自主神经张力、神经激素状态的变化），为将来R 01应用于更大规模的随机临床试验做准备。第三个项目将评估心血管疾病和心力衰竭患者目前可用的心脏康复计划，开始探索将身心锻炼纳入这些康复计划，并了解感知到的成功的心理社会计划组成部分（例如，可以增强患者自我效能和程序依从性的因素）。 完成拟议的研究和职业发展活动将提高叶博士进行以患者为导向的研究的能力，并使她能够实现她的职业目标，成为一名独立的临床研究人员，研究CAM疗法及其在心脏病患者中的应用。

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.