Ignite Creation Date:
2024-05-05 @ 12:02 PM
Last Modification Date:
2024-10-26 @ 9:19 AM
Study NCT ID:
NCT00224835
Status:
COMPLETED
Last Update Posted:
2016-05-13
First Post:
2005-09-21
Brief Title:
Mindfulness-Based Stress Reduction and Myocardial Ischemia
Sponsor:
University of Florida
Organization:
University of Florida
Study Overview
Official Title:
Mindfulness-Based Stress Reduction and Myocardial Ischemia
Status:
COMPLETED
Status Verified Date:
2016-05
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The principal objective of the study is to evaluate the effectiveness of a widely used complementary medicine intervention mindfulness-based stress reduction MBSR in which mindfulness meditation and yoga are the principal components in the treatment of a chronic often fatal illness that affects tens of millions of Americans The investigators propose to conduct a single center randomized controlled trial in which 150 patients will be assigned to either a mindfulness meditation condition a disease education control condition or a stress-monitoring usual care control condition They will test the following specific hypotheses
1 In comparison to either of the control conditions significantly more coronary artery disease CAD patients in the mindfulness meditation condition will demonstrate reductions in mental stress-induced ischemia
2 The ratio of low-to-high frequency of spectral power in heart rate variability during ambulatory monitoring will be significantly decreased following the participation in a stress reduction program compared with those in a disease education or usual care condition
3 Patients in the mindfulness meditation condition will report greater improvement in quality of life ie reductions in general psychological symptomology anger anxiety depression and daily stress along with increases in optimism and stress coping efficacy than patients in either of the control conditions
4 Day-to-day variability in self-reported mental stress will be inversely related to day-to-day stress coping efficacy in the entire sample and time spent in mindfulness practice in the active treatment condition and these relationships will be maintained over a 3-month follow-up
5 Patients with CAD and mental stress ischemia who show an abnormal peripheral artery response during baseline studies will show a significant improvement after mindfulness intervention
Abnormal responses will be defined as peripheral arterial tonometry PAT tracings that decrease greater than 20 in amplitude during mental stress
1 In comparison to either of the control conditions significantly more coronary artery disease CAD patients in the mindfulness meditation condition will demonstrate reductions in mental stress-induced ischemia
2 The ratio of low-to-high frequency of spectral power in heart rate variability during ambulatory monitoring will be significantly decreased following the participation in a stress reduction program compared with those in a disease education or usual care condition
3 Patients in the mindfulness meditation condition will report greater improvement in quality of life ie reductions in general psychological symptomology anger anxiety depression and daily stress along with increases in optimism and stress coping efficacy than patients in either of the control conditions
4 Day-to-day variability in self-reported mental stress will be inversely related to day-to-day stress coping efficacy in the entire sample and time spent in mindfulness practice in the active treatment condition and these relationships will be maintained over a 3-month follow-up
5 Patients with CAD and mental stress ischemia who show an abnormal peripheral artery response during baseline studies will show a significant improvement after mindfulness intervention
Abnormal responses will be defined as peripheral arterial tonometry PAT tracings that decrease greater than 20 in amplitude during mental stress
Detailed Description:
BACKGROUND
Acute and chronic psychological stress has been shown to be a risk factor for cardiac events More recently with the advent of new technology allowing cardiac imaging acute psychological stressors have been shown to produce myocardial ischemia in certain subsets of patients with CAD Several studies have shown that the production of myocardial ischemia in response to acute psychological stress in the laboratory is a marker for adverse events in patients with CAD Several pathways by which psychologically induced stress may trigger ischemic events have been proposed and a number of studies have provided evidence that stress affects ischemic events via these pathways Stress interventions have been shown to have a positive impact on CAD outcomes with only one thus far testing their effects on ischemic events Furthermore some studies have reported positive results with coronary risk factors using meditation and yoga Current clinical meditation literature suggests that a mindfulness meditation-based stress reduction program ie multicomponent psychoeducational program based in mindfulness meditation that cultivates an ability to pay attention to ones moment-to-moment experiences in a nonjudgmental nonreactive fashion will be able to reduce stress reactivity in CAD patients It is predicted that such reductions in stress reactivity will result in reduced radionuclide imaged perfusion defects during a laboratory mental stress task Although it has not been used with heart patients it has demonstrated good results with both stress and symptomology in the general and other medical populations We believe that similar results will be seen in CAD patients with effects acting through the following pathways 1 decreased sympathetic tone and 2 increased parasympathetic tone The overall goal of the proposed study is to evaluate the efficacy of a meditation-based stress reduction program for the reduction of mental stress-induced ischemia
DESIGN NARRATIVE
To test the efficacy of MBSR patients will be randomly assigned to one of three groups The MBSR condition will be provided training in mindfulness meditation methods The patient education control group will be provided information about CAD in a didactic format This condition will control for the nonspecific effects of contact in a therapeutic setting Excluding intervals spent in personal meditation practice in the mindfulness meditation condition the length of sessions in the two intervention conditions will be approximately equal The third group a stress-monitoring usual care control condition will control for the effects of symptom measurement reactivity in patients receiving routine medical care
Acute and chronic psychological stress has been shown to be a risk factor for cardiac events More recently with the advent of new technology allowing cardiac imaging acute psychological stressors have been shown to produce myocardial ischemia in certain subsets of patients with CAD Several studies have shown that the production of myocardial ischemia in response to acute psychological stress in the laboratory is a marker for adverse events in patients with CAD Several pathways by which psychologically induced stress may trigger ischemic events have been proposed and a number of studies have provided evidence that stress affects ischemic events via these pathways Stress interventions have been shown to have a positive impact on CAD outcomes with only one thus far testing their effects on ischemic events Furthermore some studies have reported positive results with coronary risk factors using meditation and yoga Current clinical meditation literature suggests that a mindfulness meditation-based stress reduction program ie multicomponent psychoeducational program based in mindfulness meditation that cultivates an ability to pay attention to ones moment-to-moment experiences in a nonjudgmental nonreactive fashion will be able to reduce stress reactivity in CAD patients It is predicted that such reductions in stress reactivity will result in reduced radionuclide imaged perfusion defects during a laboratory mental stress task Although it has not been used with heart patients it has demonstrated good results with both stress and symptomology in the general and other medical populations We believe that similar results will be seen in CAD patients with effects acting through the following pathways 1 decreased sympathetic tone and 2 increased parasympathetic tone The overall goal of the proposed study is to evaluate the efficacy of a meditation-based stress reduction program for the reduction of mental stress-induced ischemia
DESIGN NARRATIVE
To test the efficacy of MBSR patients will be randomly assigned to one of three groups The MBSR condition will be provided training in mindfulness meditation methods The patient education control group will be provided information about CAD in a didactic format This condition will control for the nonspecific effects of contact in a therapeutic setting Excluding intervals spent in personal meditation practice in the mindfulness meditation condition the length of sessions in the two intervention conditions will be approximately equal The third group a stress-monitoring usual care control condition will control for the effects of symptom measurement reactivity in patients receiving routine medical care
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| R01HL072059 | NIH | None | httpsreporternihgovquickSearchR01HL072059 |