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Effects of cardiac rehabilitation with and without meditation on myocardial blood flow using quantitative positron emission tomography: A pilot study

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Psychosocial stress is recognized as a risk factor for coronary heart disease (CHD). High rates of CHD in African-Americans may be related to psychosocial stress. However, standard cardiac rehabilitation (CR) usually does not include a systematic stress-reduction technique. Previous studies suggest that the Transcendental Meditation (TM) technique may reduce CHD risk factors and clinical events. This pilot study explored the effects of standard CR with and without TM on a measure of CHD in African-American patients.

Methods

Fifty-six CHD patients were assigned to CR, CR + TM, TM alone, or usual care. Testing was done at baseline and after 12 weeks. The primary outcome was myocardial flow reserve (MFR) assessed by 13N-ammonia positron emission tomography (PET). Secondary outcomes were CHD risk factors. Based on guidelines for analysis of small pilot studies, data were analyzed for effect size (ES).

Results

For 37 patients who completed posttesting, there were MFR improvements in the CR + TM group (+20.7%; ES = 0.64) and the TM group alone (+12.8%; ES = 0.36). By comparison, the CR-alone and usual care groups showed modest changes (+ 5.8%; ES = 0.17 and − 10.3%; ES = − 0.31), respectively. For the combined TM group, MFR increased (+ 14%, ES = 0.56) compared to the combined non-TM group (− 2.0%, ES = − 0.08).

Conclusions

These pilot data suggest that adding the TM technique to standard cardiac rehabilitation or using TM alone may improve the myocardial flow reserve in African-American CHD patients. These results may be applied to the design of controlled clinical trials to definitively test these effects.

Trial registration

ClinicalTrials.gov registration # NCT01810029.

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Abbreviations

CR:

Cardiac rehabilitation

TM:

Transcendental Meditation

PET:

Positron emission tomography

MFR:

Myocardial flow reserve

LAD:

Left anterior descending artery

LCX:

Left circumflex artery

RCA:

Right coronary artery

ES:

Effect size

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Acknowledgements

The authors are grateful to Magnolia Jimenez for her data collection and administrative contributions, Laura Alcorn for data management, and Linda Heaton and Carol Jarvis for administrative and technical support. Ines Spinal, Claudia Rodriguez, and Josh Pittman taught the Transcendental Meditation program.

Disclosures

All the authors report that there are no relevant, financial conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA

    Sabahat Bokhari MD, FACC

  2. Center for Natural Medicine and Prevention, Maharishi University of Management Research Institute, 2100 Mansion Drive, Maharishi Vedic City, IA, 52556, USA

    Robert H. Schneider MD, FACC, John W. Salerno PhD, Maxwell V. Rainforth PhD, Carolyn Gaylord-King PhD & Sanford I. Nidich EdD

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  1. Sabahat Bokhari MD, FACC
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Correspondence to Robert H. Schneider MD, FACC.

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Funding

This study was supported by a Grant from NIH—National Heart, Lung and Blood Institute, # HL 100386.

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Bokhari, S., Schneider, R.H., Salerno, J.W. et al. Effects of cardiac rehabilitation with and without meditation on myocardial blood flow using quantitative positron emission tomography: A pilot study. J. Nucl. Cardiol. 28, 1596–1607 (2021). https://doi.org/10.1007/s12350-019-01884-9

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