Wagner-Skacel Jolana, Mörkl Sabrina, Dalkner Nina, Fellendorf Frederike, Fitz Werner, Brix Bianca, Neshev Ruslan, Wedenig Sarah, Mächler Petra, Dorr Andreas, Picha Rainer, Rudlof Maximilian E, Bartel Till O, Tatschl Josef M, Gostner Johanna M, Bengesser Susanne A, Reininghaus Eva Z, Jenewein Josef, Goswami Nandu
Department of Medical Psychology and Psychotherapy, Medical University Graz, 8036 Graz, Austria.
Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria.
Antioxidants (Basel). 2021 Sep 7;10(9):1425. doi: 10.3390/antiox10091425.
Multicomponent cardiac rehabilitation (CR) is a secondary prevention strategy for cardiac patients to tackle stress and psychosocial wellbeing. However, there is a lack of data on its psychoneuroimmunological effects and of biomarkers to determine individual risk and to develop treatment strategies. We conducted a pilot randomized controlled trial (RCT) to investigate the feasibility of deriving psychophysiological stress markers in patients with cardiovascular diseases. Thirty individuals with cardiovascular disease (mean age 58.8 years; 23.3% female) were enrolled and randomized into three treatment groups: standard rehabilitation, yoga, or transcendental meditation (TM). Depression, anxiety, sleep, stress perception, personality functioning, hair cortisol, serum tryptophan, kynurenine and neopterin concentrations were estimated at baseline and after a four-week intervention. Hair cortisol levels decreased significantly after rehabilitation in all groups = 15.98, < 0.001). In addition, personality functioning improved in all patients over time. Participants with impairments in personality functioning showed a positive correlation with baseline neopterin that did not remain significant after Bonferroni correction. Concentrations of serum tryptophan and its metabolite kynurenine did not change significantly. This pilot RCT provides preliminary evidence of multicomponent CR leading to stabilization of hair cortisol levels and improved psychophysiological wellbeing and personality functioning. Impairments in personality functioning were correlated with neopterin levels, which may impact the symptomatology and outcome.
多组分心脏康复（CR）是心脏病患者应对压力和心理社会健康的二级预防策略。然而，关于其心理神经免疫学效应以及用于确定个体风险和制定治疗策略的生物标志物的数据却很缺乏。我们进行了一项试点随机对照试验（RCT），以研究在心血管疾病患者中得出心理生理应激标志物的可行性。招募了30名心血管疾病患者（平均年龄58.8岁；23.3%为女性），并将他们随机分为三个治疗组：标准康复组、瑜伽组或超觉静坐（TM）组。在基线时以及四周干预后，对抑郁、焦虑、睡眠、压力感知、人格功能、头发皮质醇、血清色氨酸、犬尿氨酸和新蝶呤浓度进行了评估。所有组康复后头发皮质醇水平均显著下降（F = 15.98，P < 0.001）。此外，随着时间推移，所有患者的人格功能都有所改善。人格功能受损的参与者与基线新蝶呤呈正相关，经Bonferroni校正后该相关性不再显著。血清色氨酸及其代谢产物犬尿氨酸的浓度没有显著变化。这项试点RCT提供了初步证据，表明多组分CR可导致头发皮质醇水平稳定，并改善心理生理健康和人格功能。人格功能受损与新蝶呤水平相关，这可能会影响症状和预后。
