瑜伽与心血管健康试验（YACHT）：一项基于英国的随机机制研究，针对急性冠状动脉事件后进行瑜伽干预加常规护理与单纯常规护理的比较。
Yoga and Cardiovascular Health Trial (YACHT): a UK-based randomised mechanistic study of a yoga intervention plus usual care versus usual care alone following an acute coronary event.
机构信息
Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK
York Hospitals NHS Trust, York, UK.
出版信息
BMJ Open. 2019 Nov 3;9(11):e030119. doi: 10.1136/bmjopen-2019-030119.
OBJECTIVE
To determine the effects of yoga practice on subclinical cardiovascular measures, risk factors and neuro-endocrine pathways in patients undergoing cardiac rehabilitation (CR) following acute coronary events.
DESIGN
3-month, two-arm (yoga +usual care vs usual care alone) parallel randomised mechanistic study.
SETTING
One general hospital and two primary care CR centres in London. Assessments were conducted at Imperial College London.
PARTICIPANTS
80 participants, aged 35-80 years (68% men, 60% South Asian) referred to CR programmes 2012-2014.
INTERVENTION
A certified yoga teacher conducted yoga classes which included exercises in stretching, breathing, healing imagery and deep relaxation. It was pre-specified that at least 18 yoga classes were attended for inclusion in analysis. Participants and partners in both groups were invited to attend weekly a 6- to 12-week local standard UK National Health Service CR programme.
MAIN OUTCOME MEASURES
(i) Estimated left ventricular filling pressure (E/e'), (ii) distance walked, fatigue and breathlessness in a 6 min walk test, (iii) blood pressure, heart rate and estimated peak VO following a 3 min step-test. Effects on the hypothalamus-pituitary-adrenal axis, autonomic function, body fat, blood lipids and glucose, stress and general health were also explored.
RESULTS
25 participants in the yoga + usual care group and 35 participants in the usual care group completed the study. Following the 3-month intervention period, E/e' was not improved by yoga (E/e': between-group difference: yoga minus usual care:-0.40 (-1.38, 0.58). Exercise testing and secondary outcomes also showed no benefits of yoga.
CONCLUSIONS
In this small UK-based randomised mechanistic study, with 60 completing participants (of whom 25 were in the yoga + usual care group), we found no discernible improvement associated with the addition of a structured 3-month yoga intervention to usual CR care in key cardiovascular and neuroendocrine measures shown to be responsive to yoga in previous mechanistic studies.
TRIAL REGISTRATION NUMBER
NCT01597960; Pre-results.
目的
确定瑜伽练习对急性冠状动脉事件后接受心脏康复（CR）的患者亚临床心血管指标、风险因素和神经内分泌途径的影响。
设计
3 个月、双臂（瑜伽+常规护理与常规护理）平行随机机制研究。
设置
伦敦一家综合医院和两家初级保健 CR 中心。评估在伦敦帝国理工学院进行。
参与者
2012-2014 年被转介到 CR 项目的 80 名年龄在 35-80 岁的患者（68%为男性，60%为南亚人）。
干预措施
一名认证瑜伽教师教授瑜伽课程，包括伸展、呼吸、疗愈意象和深度放松练习。规定至少参加 18 次瑜伽课程才能进行分析。两组的参与者和伴侣都被邀请参加每周一次的为期 6-12 周的当地标准英国国家卫生服务 CR 项目。
主要观察指标
（i）估计左心室充盈压（E/e'），（ii）6 分钟步行试验中的步行距离、疲劳和呼吸困难，（iii）3 分钟踏步试验后的血压、心率和估计峰值 VO。还探讨了对下丘脑-垂体-肾上腺轴、自主功能、体脂、血脂和血糖、压力和一般健康的影响。
结果
瑜伽+常规护理组有 25 名参与者和常规护理组有 35 名参与者完成了研究。在 3 个月的干预期后，瑜伽并未改善 E/e'（E/e'：组间差异：瑜伽减去常规护理：-0.40[-1.38，0.58]）。运动测试和次要结局也没有显示瑜伽的益处。
结论
在这项基于英国的小型随机机制研究中，有 60 名完成的参与者（其中 25 名在瑜伽+常规护理组），我们没有发现与在常规 CR 护理中增加结构化 3 个月瑜伽干预相关的可识别改善，在之前的机制研究中，瑜伽对关键心血管和神经内分泌指标有反应。
试验注册号
NCT01597960；预结果。
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