基于瑜伽的心脏康复计划对急性心肌梗死患者内皮功能、氧化应激和炎症标志物的影响：一项随机对照试验
Effect of Yoga-Based Cardiac Rehabilitation Program on Endothelial Function, Oxidative Stress, and Inflammatory Markers in Acute Myocardial Infarction: A Randomized Controlled Trial.
作者信息
Patil Satish Gurunathrao, Sobitharaj Edmin Christa, Chandrasekaran Ambalam Mahendrakumar, Patil Shankar S, Singh Kalpana, Gupta Ruby, Deepak Kishore Kumar, Jaryal Ashok Kumar, Chandran Dinu Santha, Kinra Sanjay, Roy Ambuj, Prabhakaran Dorairaj
机构信息
Department of Physiology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India.
Department of Physiology, Shri B.M.Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India.
出版信息
Int J Yoga. 2024 Jan-Apr;17(1):20-28. doi: 10.4103/ijoy.ijoy_40_24. Epub 2024 May 13.
AIMS
The aim of this study was to evaluate the effects of yoga-based cardiac rehabilitation (Yoga-CaRe) on the endothelial system, oxidative stress, and inflammatory markers in patients with acute myocardial infarction (MI).
METHODS
A sub-study was conducted in two clinical sites of the Yoga-CaRe trial (a multicenter randomized controlled trial). Participants with acute MI were randomized and allocated to either the Yoga-CaRe program (13 sessions with encouragement to home practice) or enhanced standard care (three educational sessions). Endothelial function, oxidative stress, and inflammatory biomarkers were assessed using biomarkers such as asymmetric dimethylarginine (ADMA), endothelial nitric oxide synthase (eNOS), endothelin-1 (ET-1), E-selectin, P-selectin, vascular cell adhesion molecule (VCAM), intercellular cell-adhesion molecule-1, total nitric oxide concentration (NOx), oxidized low-density lipoprotein (Oxd-LDL), superoxide dismutase, total antioxidant capacity (TAOC), tumor necrosis factor-alpha (TNFα), and C-reactive protein (CRP) at baseline and 12 weeks. Laboratory and statistical analysis were done by staff blinded to group allocation.
RESULTS
Eighty-two patients (of the 110 patients recruited) completed the study. The mean age was 53.1 ± 10.6 and 51.9 ± 10.7 years in enhanced standard care and Yoga-CaRe group, respectively. At 12 weeks, Yoga-CaRe significantly reduced ADMA, ET-1, and ICMA-1 than the enhanced standard care group. Although E-selectin and VCAM at 12 weeks were reduced in both groups, enhanced standard care had a significantly higher reduction than the Yoga-CaRe group. Among markers of oxidative stress, TAOC increased in the Yoga-CaRe group. We found no difference in eNOS, NOx, P-selectin, TNFα, CRP, and Oxd-LDL between the two groups.
CONCLUSION
Yoga-CaRe improved the endothelial function (through a reduction in ET-1 and modulating adhesion molecules) and enhanced antioxidant capacity.
目的
本研究旨在评估基于瑜伽的心脏康复（Yoga-CaRe）对急性心肌梗死（MI）患者内皮系统、氧化应激和炎症标志物的影响。
方法
在Yoga-CaRe试验（一项多中心随机对照试验）的两个临床地点进行了一项子研究。急性心肌梗死患者被随机分配到Yoga-CaRe计划组（13节课程并鼓励在家练习）或强化标准护理组（3节教育课程）。使用不对称二甲基精氨酸（ADMA）、内皮型一氧化氮合酶（eNOS）、内皮素-1（ET-1）、E-选择素、P-选择素、血管细胞粘附分子（VCAM）、细胞间细胞粘附分子-1、总一氧化氮浓度（NOx）、氧化型低密度脂蛋白（Oxd-LDL）、超氧化物歧化酶、总抗氧化能力（TAOC）、肿瘤坏死因子-α（TNFα）和C反应蛋白（CRP）等生物标志物在基线和12周时评估内皮功能、氧化应激和炎症生物标志物。实验室和统计分析由对分组情况不知情的工作人员进行。
结果
（招募的110名患者中）82名患者完成了研究。强化标准护理组和Yoga-CaRe组的平均年龄分别为53.1±10.6岁和51.9±10.7岁。在12周时，与强化标准护理组相比，Yoga-CaRe组显著降低了ADMA、ET-1和ICMA-1。虽然两组在12周时E-选择素和VCAM均降低，但强化标准护理组的降低幅度明显高于Yoga-CaRe组。在氧化应激标志物中，Yoga-CaRe组的TAOC增加。我们发现两组之间eNOS、NOx、P-选择素、TNFα、CRP和Oxd-LDL没有差异。
结论
Yoga-CaRe改善了内皮功能（通过降低ET-1和调节粘附分子）并增强了抗氧化能力。
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