Effects of a Qur'an recitation intervention on SERCA2a and PIEZO1 gene expression, psychological well-being, and cardiac contractility in patients with heart failure with reduced ejection fraction: A randomized controlled trial

Abstract

Existing studies have shown that Quranic recitation could improve anxiety, depression, and quality of life; however, whether these psychological benefits translate into objective improvements in cardiac function or modulation of myocardial molecular pathways remains unknown. The aim of this study was to evaluate the effects of structured Quranic recitation on SERCA2a and PIEZO1 gene expression, psychological outcomes, and cardiac contractility in patients with heart failure with reduced ejection fraction (HFrEF). In this randomized controlled trial, 30 patients with stable HFrEF were allocated in a 1:1:1 ratio to a one-juz recitation group, a half-juz recitation group, or a control group receiving standard medical therapy alone. Quranic recitation was performed daily for 30 days. Assessments were conducted at baseline, day 15, and day 30 and included SERCA2a and PIEZO1 mRNA expression, Depression Anxiety Stress Scales–42 (DASS-42) scores, left ventricular ejection fraction (LVEF), left ventricular outflow tract velocity–time integral (LVOT-VTI), and LVOT peak velocity (LVOT Vmax). In the one-juz recitation group, depression, anxiety, and stress scores decreased significantly (all p<0.05), accompanied by improvements in LVOT-VTI (p=0.019), LVOT Vmax (p=0.001), and LVEF (p=0.011). The half-juz recitation group also showed significant reductions in depression (p=0.039) and anxiety (p=0.012), but not in stress scores (p=0.277), along with improvements in LVOT-VTI (p=0.044) and LVEF (p=0.012). No significant changes were observed in SERCA2a or PIEZO1 gene expression in any group (p>0.05), although a trend toward increased SERCA2a expression was observed in the one-juz recitation group. These findings suggest that daily Quranic recitation for 30 days improved psychological well-being and cardiac contractility in patients with HFrEF. Although no significant changes were observed in SERCA2a or PIEZO1 expression, a trend toward SERCA2a upregulation was observed, warranting further investigation in larger studies with longer follow-up.