Effcet Of Tai Chi On Cardiac Function And Quality Of Life In Community Patients With Coronary Heart Disease

ObjectiveTo observe the effect of Tai Chi on cardiac function and quality of life of patients with coronary heart disease in community.MethodsThirty(30)patients with CHD were recruited from Daqiao Street,Yangpu District,Shanghai.They were randomly divided into two groups of Tai Chi(15)and control group(15).The control group received a routine drug treatment,and Tai Chi group received an exercise intervention of Yang 24-style Tai Chi.The Tai Chi exercise intervention program was undertaken for 12 weeks,an hour 3 times a week.The intensity of exercise was monitored according to the target heart rate(less than the target heart rate)and Borg scale(Borg score?14).Baseline,mid and post-test were performed 6 and 12 weeks respectively.Observation indicators included:6MWD,electrocardiogr-am indicators,QTd and QTcd,ECG efficacy observed by ST-T,CHD risk factors(blood pressure,weight,blood lipid,heart rate),clinical efficacy indicators(cardiac function classification efficacy,clinical symptoms efficacy),SF36 quality of life scale.Statistical analysis methods were: Repeated measurement variance analysis to judge the impact of different interventions on CHD patients over time.Chi-square test was used for counting data and rank sum test was used for rank data.All data were analyzed and processed by SPSS21.0 statistical software.P < 0.05 was significant difference,P < 0.01 was significant difference.Results(1)At baseline,there were no significant differences in demographic characteristics between the two groups,such as sex(10 males and 5 females in Tai Chi group,same number in the control group.),age(Tai Chi group 61.40±11.72 years vs control group 67.27±8.35 years,P=0.126),body mass index(Tai Chi group 23.23±2.41 vs control group 26.27±7.14,P=0.136),resting heart rate(Tai Chi group 80.66±14.89 vs control group 75.33±15.98,P=0.352).At baseline,no significant difference was found between the two groups in all the observed indicators.(2)There was intersubjective effect in 6MWD(F=5.762,P=0.024).There was a significant difference in 6 MWD between the two groups in the time of midterm test(Tai Chi group 473.13±75.08 m vs control group 383.27±103.64 m,P=0.017)and final test(Tai Chi group 510.40±78.52 m vs control group 373.09±104.91 m,P=0.001).There was a significant difference in 6MWD between midterm test 473.13±75.08 m and final test 510.40±78.52 m in Tai Chi group compared with baseline 393.67±98.42m(P < 0.001;P < 0.001).No significant changes were found in the control group.(3)There was an intersubjective effect on QTd(F=4.979,P=0.034).There was a significant difference in QTd between the two groups at final test(Tai Chi group 50.53±12.27 ms vs control group 68.47±19.29ms;F=9.230,P=0.005).There was a sig-nificant difference in QTd between midterm test 52.33±15.71 ms and final test 50.53±12.27 ms in Tai Chi group compared with baseline 63.73±12.75ms(P=0.027;P =0.011).There was an intersubjective effect on QTcd(F=4.443,P=0.044).There was a significant difference in the finaltest time between the two groups(Tai Chi group 53.47±13.67 ms vs control group 72.40±20.13ms;F=9.081,P=0.005).There was a significant difference in QTcd for final test 53.47±13.67 ms in Tai Chi group compared with baseline 69.27±16.35ms(P=0.009).No significant changes were found in the control group.(4)There was no significant difference in TC,HDLC,LDLC and TG between the two groups before and after intervention.SBP had intersubjective effect(F=5.593,P=0.025).There was a significant difference between the two groups in final test time(Tai Chi group111.27±11.81 mmHg vs control group 126.40±10.85mmHg;F=13.357,P=0.001).There was no intersubjective effect in DBP(F=1.462,P=0.237),but there was significant difference between the two groups in the time of final test(Tai Chi group 68.80±11.09 mmHg vs control group79.67±11.62mmHg;F=6.866,P=0.014)and there was a significant difference in DBP between midterm test 71.20±9.84 mmHg and final test 68.80±11.09 mmHg in Tai Chi group compared with baseline 78.80±9.73 mm Hg(P=0.048,P=0.011).There was no significant change in body weight.Although resting heart rate had no intersubjective effect(F=0.145;P=0.706),there was a significant difference between the two groups in the time of final test(Tai Chi group 72.07±7.6 vs control group 79.80±9.73;P=0.022).(5)After intervention,the effects of electrocardiogram(P=0.049),cardiac function grading(P=0.041),chest tightness(P=0.007)and weakness(P=0.021)in the Tai Chi group were significantly different from those in the control group.The PF(F=10.906,P=0.003),RP(F=10.151,P=0.004),GH(F=6.340,P=0.017),VT(F=6.521,P=0.016),SF(F=5.711,P=0.016),RE(F=4.564,P=0.042),PHC(F=11.42,P=0.002),MHC(F=8.239,P=0.008)of the SF36 Tai Chi group had intersubjective effects compared with the control group.Conclusion(1)The 12 week Yang's Tai Chi exercise increased the 6MWD of CHD patients.(2)Tai Chi can reduce the level of QTd and QTcd in ECG of CHD patients,and optimize the changes of ST-T,and help improve the state of myocardial ischemia in CHD patients.(3)Tai Chi can improve the clinical symptoms of chest tightness and weakness in patients with CHD and the effect of cardiac function grading.(4)Tai Chi can improve the quality of life of CHD patients.Tai Chi is a safe and effective exercise rehabilitation strategy suitable for community patients with coronary heart disease.