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Editorial

Stress Reduction, Meditation and Mindfulness Program for Heart Failure Patients: Some Light in the Darkness

The study entitled “Impact of a Stress Reduction, Meditation, and Mindfulness Program in Patients with Chronic Heart Failure: A Randomized Controlled Trial” has raised a very important subject to be addressed in patients with heart failure and aimed to do so by conducting a randomized clinical trial. The impact of patients’ stress, depression, lack of life purpose, and psychological changes imposed by a chronic and debilitating disease definitely contributes to worsening quality of life and possibly to worse prognosis.^, To assess this impact and to research possible therapies is deeply needed. The authors should be recognized for their interest and huge effort in conducting such a laborious trial.

The study, however, has some deficiencies. Although the authors claim to be a heart failure with reduced ejection fraction (HFrEF) trial, the study included approximately half of the patients with HFrEF. Despite the heterogeneity of the sample, one-third of patients in the intervention group were lost to follow-up, while no patients were lost in the control group. Therefore, even having screened more than two hundred individuals, only 13 patients were actually submitted to intervention. The authors do not inform us of how these patients were pharmacologically treated, but given that the study was conducted four years ago, one can assume patients’ treatment was outdated.

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Original Article

Impact of a Stress Reduction, Meditation, and Mindfulness Program in Patients with Chronic Heart Failure: A Randomized Controlled Trial

Vaisnava Nogueira Cavalcante et al. Evandro Tinoco Mesquita Ana Carla Dantas Cavalcanti Jacqueline Sampaio dos Santos Miranda … Paola Pugian Jardim Glaucio Martins da Silva Bandeira Lais Marcelle Rufino Guimarães Isabella Christina Diniz de Lemos Venâncio Nathalia Manoela Condeixa Correa Angela Maria Rodrigues Dantas João Carlos Tress Ana Catarina Romano Fabiana Bergamin Muccillo Marina Einstoss Barbosa Siqueira Glaucia Cristina Andrade Vieira

Abstract

Background

Heart Failure is a significant public health problem leading to a high burden of physical and psychological symptoms despite optimized therapy.

Objective

To evaluate primarily the impact of a Stress Reduction, Meditation, and Mindfulness Program on stress reduction of patients with Heart Failure.

Methods

A randomized and controlled clinical trial assessed the effect of a stress reduction program compared to conventional multidisciplinary care in two specialized centers in Brazil. The data collection period took place between April and October 2019. Thirty-eight patients were included and allocated to the intervention or control groups. The intervention took place over 8 weeks. The protocol assessed the scales of perceived stress, depression, quality of life, anxiety, mindfulness, quality of sleep, a 6-minute walk test, and biomarkers analyzed by a blinded team, considering a p-value <0.05 statistically significant.

Results

The intervention resulted in a significant reduction in perceived stress from 22.8 ± 4.3 to 14.3 ± 3.8 points in the perceived stress scale-14 items in the intervention group vs. 23.9 ± 4.3 to 25.8 ± 5.4 in the control group (p-value<0.001). A significant improvement in quality of life (p-value=0.013), mindfulness (p-value=0.041), quality of sleep (p-value<0.001), and the 6-minute walk test (p-value=0.004) was also observed in the group under intervention in comparison with the control.

Conclusion

The Stress Reduction, Meditation, and Mindfulness Program effectively reduced perceived stress and improved clinical outcomes in patients with chronic Heart Failure.

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Review Article

Effectiveness of Mindfulness Meditation Programs in the Promotion of Quality of Life in Patients with Heart Failure: A Systematic Review

Vaisnava Nogueira Cavalcante et al. Ana Carla Dantas Cavalcanti Juliana de Melo Vellozo Pereira Tinoco Lyvia da Silva Figueiredo Evandro Tinoco Mesquita

Abstract

Background:

Despite optimal medical treatment, many heart failure (HF) patients continue to show a high prevalence of symptoms, which contributes to a high morbidity and poor health-related quality of life (HRQL). Mindfulness meditation may be effective in improving the quality of life in these patients.

Objective:

A systematic review was conducted to evaluate if mindfulness meditation programs are effective in promoting and improving the quality of life in patients with heart failure.

Methods:

The PubMed (MEDLINE), Cumulative Index of Nursing and Allied Health (CINAHL), LILACS, Cochrane Library, and Scopus databases were searched between October and November of 2019. Articles were selected if they evaluated mindfulness intervention, with an experimental or quasi-experimental design, in adults with heart failure and measured health-related quality of life.

Results:

This systematic review identified 108 studies through database searches. After applying the inclusion and exclusion criteria, a total of three studies were considered qualified. These studies took place in the Netherlands, the USA, and Brazil, and occurred between 2005 and 2015. Sample sizes varied from 19 to 215, and the average range of participants within each study varied from 43.2 to 75.4 years. Compared to control programs, mindfulness-based meditation programs improved the quality of life in two studies (p= 0.041 and p=0.03).

Conclusion:

Mindfulness-based meditation programs improved the quality of life in patients with HF. Therefore, there is limited data to strengthen this recommendation to this population, and future research is warranted in order to present consistency in the intervention protocols.

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Stress Reduction, Meditation and Mindfulness Program for Heart Failure Patients: Some Light in the Darkness

Impact of a Stress Reduction, Meditation, and Mindfulness Program in Patients with Chronic Heart Failure: A Randomized Controlled Trial

Abstract

Background

Objective

Methods

Results

Conclusion

Effectiveness of Mindfulness Meditation Programs in the Promotion of Quality of Life in Patients with Heart Failure: A Systematic Review

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

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