Mental health conditions (eg, depression, anxiety) are highly prevalent in cardiovascular populations, impacting treatment adherence, functional recovery, quality of life, and long-term outcomes. Mechanisms underpinning...Mental health conditions (eg, depression, anxiety) are highly prevalent in cardiovascular populations, impacting treatment adherence, functional recovery, quality of life, and long-term outcomes. Mechanisms underpinning the heart-brain-mind axis are multifactorial, involving behavioral, cognitive, neuroendocrine, autonomic, and systemic inflammatory processes. Integrating pharmacological and non-pharmacological interventions into cardiac rehabilitation enhances both psychological well-being and cardiovascular prognosis. Nonetheless, the implementation of such interventions remains inconsistent, underscoring cardiac rehabilitation as an underused yet strategic framework for embedding mental health care into secondary prevention.
Mental health conditions-including depression, anxiety, posttraumatic stress disorder, and sleep disorders-are highly prevalent after acute cardiovascular events and independently worsen prognosis, quality of life, and a...Mental health conditions-including depression, anxiety, posttraumatic stress disorder, and sleep disorders-are highly prevalent after acute cardiovascular events and independently worsen prognosis, quality of life, and adherence to secondary prevention. Evidence supports a multimodal approach combining psychotherapy, pharmacotherapy, and structured physical exercise, with cardiac rehabilitation as a central platform for many patients. Early screening and collaborative models of care integrating psychiatric and psychological care into cardiology pathways are critical. Research priorities include cardio-specific trials of psychotherapy, psychopharmacotherapy, and stepped-care interventions.
This narrative article examines the role of positive psychological interventions, including mindfulness-based approaches, in cardiovascular health, with a focus on clarifying optimal frequency and duration of delivery. E...This narrative article examines the role of positive psychological interventions, including mindfulness-based approaches, in cardiovascular health, with a focus on clarifying optimal frequency and duration of delivery. Evidence from 18 randomized trials, supplemented by single arm and meta-analyses, is synthesized, showing consistent improvements in risk factors, health behaviors, and medication adherence, though long-term outcomes remain uncertain. Interventions reviewed include gratitude journaling, optimism training, and mindfulness programs delivered in person, hybrid, or digital formats over 6 to 12 weeks. However, there remains a need for research on standardized dosing, diverse populations, and scalable delivery models.
Psychological factors are modifiable determinants of cardiovascular disease (CVD) incidence and mortality. Among those, affect regulation -the ways individuals cope with stressors and regulate emotions- is of special int...Psychological factors are modifiable determinants of cardiovascular disease (CVD) incidence and mortality. Among those, affect regulation -the ways individuals cope with stressors and regulate emotions- is of special interest because it is a core psychotherapy target. Growing research from general and cardiac populations suggests adaptive affect regulation (eg, reinterpreting challenging situations) predicts lower CVD incidence/mortality risk, and related risk factors (eg, diabetes onset, unhealthy behaviors), whereas maladaptive affect regulation (eg, disengaging from stressors) predicts worse outcomes. Furthermore, psychotherapies enhancing affect regulation (eg, cognitive-behavioral therapy) are beneficial for mental health and appear promising for certain physical health outcomes among CVD populations.
Cardiovascular disease and mental disorders are among the most common causes of disability worldwide and are one of the main reasons for economic burdens and mortality. Physical activity has a significant positive impact...Cardiovascular disease and mental disorders are among the most common causes of disability worldwide and are one of the main reasons for economic burdens and mortality. Physical activity has a significant positive impact on both types of disorders. We provide a comprehensive overview of the relationship between the effects of mental health on physical activity and, consequently, on heart health. We also provide an overview of the complex associations that could explain these connections. A total of 44 meta-analyses were included in this review. Mental illness in people with cardiovascular disease should be systematically identified and appropriately treated.
Burnout is a significant concern in cardiology, impacting both health care professionals and patient outcomes. Chronic job stress contributes to increased cardiovascular risk by disrupting autonomic regulation, increasin...Burnout is a significant concern in cardiology, impacting both health care professionals and patient outcomes. Chronic job stress contributes to increased cardiovascular risk by disrupting autonomic regulation, increasing inflammation, and exacerbating metabolic disturbances. Burnout impairs clinical performance, leading to higher rates of medical errors, reduced diagnostic accuracy, and poorer patient safety. Using Job Demands-Resources theory, this article explains how high job demands and insufficient job and personal resources create a self-reinforcing loss cycle, where burnout fuels self-undermining behaviors that further increase stress. Strategies to prevent burnout include job redesign, recovery interventions, and job crafting to optimize workload and enhance resources.
Cardiovascular disease remains a leading cause of death among workers, yet the role of work conferring increased risk as well as opportunities for prevention are often overlooked. This chapter explores job characteristic...Cardiovascular disease remains a leading cause of death among workers, yet the role of work conferring increased risk as well as opportunities for prevention are often overlooked. This chapter explores job characteristics and worker demographic factors that shape cardiovascular health. Key risk factors include long work hours, shift work, high psychological demands with low autonomy, workplace incivility and bullying, poor work-life balance, and environmental hazards, including chemical agents, noise, and air pollution. Chronic exposure to adverse working conditions triggers sustained stress responses while fostering unhealthy coping behaviors. Yet thoughtful work design can also promote heart health.
This article examines the role of social support-encompassing emotional, informational, and practical dimensions-across every stage of cardiovascular care, from early detection to treatment and recovery. Social prescribi...This article examines the role of social support-encompassing emotional, informational, and practical dimensions-across every stage of cardiovascular care, from early detection to treatment and recovery. Social prescribing is a personalized method that links patients to nonmedical support and services, such as arts and craft classes, walking groups, and coffee clubs. By encouraging meaningful engagement, social prescribing can enhance the effectiveness of social support networks and promote overall health. Thus, to effectively improve social determinants of cardiovascular health, it is crucial to integrate solutions, such as social prescribing, into health care strategies.
Whereas the placebo response is the global response to a placebo, including spontaneous remission, regression to the mean, patients' and experimenters' biases, and psychological factors, the placebo effect includes only...Whereas the placebo response is the global response to a placebo, including spontaneous remission, regression to the mean, patients' and experimenters' biases, and psychological factors, the placebo effect includes only psychological factors. It is like the difference between drug response and drug effect; whereas the former is the global response to a drug, the latter represents the specific pharmacodynamic effect. Nocebo responses and nocebo effects go in the opposite direction. Most of our knowledge in the cardiovascular system comes from clinical trials, which assess placebo responses rather than placebo effects; thus, our understanding of the underlying psychobiological mechanisms is limited.
Psychological distress (i.e., symptoms of depression, anxiety, posttraumatic stress disorder, chronic or acute stress, and negative emotions) is both a risk factor for acute coronary syndrome (ACS) and a common consequen...Psychological distress (i.e., symptoms of depression, anxiety, posttraumatic stress disorder, chronic or acute stress, and negative emotions) is both a risk factor for acute coronary syndrome (ACS) and a common consequence of ACS, with important sex differences. Compared with men, women experience a disproportionate burden of psychological distress before and after ACS. Women with ACS also have longer treatment delays, receive fewer invasive interventions, and have higher mortality rates. Screening for psychological distress in patients with ACS may help identify those at increased risk for complications.
The role of psychology within cardiovascular care has gained increased research attention. An accumulating body of research indicates that negative psychological factors, such as mental illness, stress and loneliness, co...The role of psychology within cardiovascular care has gained increased research attention. An accumulating body of research indicates that negative psychological factors, such as mental illness, stress and loneliness, contribute to the development of cardiovascular disease. Positive psychological factors, such as experiencing positive affect or being optimistic, are shown to serve as health assets to protect the heart. Accordingly, interventions aimed at increasing mental health and well-being show promising results. Yet, the integration of psychology into everyday cardiovascular care remains scarce, highlighting the need for a more holistic approach to improve both cardiovascular prevention and treatment.
Pericardial disorders are a significant subset of common cardiac conditions with notable morbidity and mortality. Advances in treatment, particularly for pericarditis, have heightened interest in diagnosis and management...Pericardial disorders are a significant subset of common cardiac conditions with notable morbidity and mortality. Advances in treatment, particularly for pericarditis, have heightened interest in diagnosis and management of these disorders. Multimodality imaging consisting of echocardiography, cardiac magnetic resonance (CMR), and cardiac computed tomography (CCT) plays a pivotal role in the assessment of these pericardial disorders. Echocardiography offers real-time functional evaluation while CMR provides more detailed tissue characterization, and CCT excels in identifying calcification and delineating anatomy. Together, these imaging techniques enable accurate diagnosis, guide management, and inform treatment strategies highlighting the value of comprehensive imaging approach in pericardial pathology.
The diagnosis and management of hypertrophic cardiomyopathy (HCM) requires accurate and comprehensive imaging. Advances in imaging technology and clinical understanding have significantly enhanced the ability to characte...The diagnosis and management of hypertrophic cardiomyopathy (HCM) requires accurate and comprehensive imaging. Advances in imaging technology and clinical understanding have significantly enhanced the ability to characterize the phenotype, assess risk, monitor disease progression, and guide therapy. This article highlights the complementary roles of echocardiography, cardiac magnetic resonance, computed tomography, and nuclear imaging in the evaluation of HCM and explores emerging research and innovation that are shaping future diagnostic and therapeutic strategies.
Inflammatory cardiomyopathies encompass a heterogeneous spectrum of disorders characterized by myocardial inflammation, including but not limited to myocarditis-which may be infectious, autoimmune, or drug/toxin-induced-...Inflammatory cardiomyopathies encompass a heterogeneous spectrum of disorders characterized by myocardial inflammation, including but not limited to myocarditis-which may be infectious, autoimmune, or drug/toxin-induced-cardiac sarcoidosis, and cardiac transplant rejection. Despite advances in diagnosis and management, these conditions remain a significant cause of left ventricular dysfunction, heart failure, arrhythmias, and cardiovascular mortality worldwide. Diagnosis is often challenging due to their patchy myocardial involvement and diverse clinical presentations. In this article, we will explore the current role of multimodality imaging in the evaluation of inflammatory cardiomyopathies- with a focus on myocarditis, identify existing knowledge gaps, and highlight future directions.
Cardiomyopathies and heart failure (HF) represent a diverse group of cardiac conditions that significantly impact global health. The increasing complexity of these disorders demands more precise tools for diagnosis, risk...Cardiomyopathies and heart failure (HF) represent a diverse group of cardiac conditions that significantly impact global health. The increasing complexity of these disorders demands more precise tools for diagnosis, risk assessment, and treatment guidance. Over the past decade, multimodality imaging has become a cornerstone in the evaluation of cardiomyopathies, offering distinct advantages in structural, functional, and tissue-level assessment that surpass any single imaging technique. Here, we provide a contemporary review of the role of echocardiography, cardiac magnetic resonance, cardiac computed tomography, nulceare imaging and artificial intelligence applications in cardiomyopathy and HF.
Multimodality imaging plays a critical role in the evaluation of prosthetic valve function. Although echocardiography-both transthoracic and transesophageal-remains the first-line diagnostic tool, complementary imaging m...Multimodality imaging plays a critical role in the evaluation of prosthetic valve function. Although echocardiography-both transthoracic and transesophageal-remains the first-line diagnostic tool, complementary imaging modalities such as cardiac computed tomography, cardiac MRI, and PET provide valuable additional information. Accurate assessment of prosthetic valve dysfunction often requires an integrative imaging approach owing to the complexity of structural and functional abnormalities. This article outlines the strengths and limitations of each imaging modality and presents illustrative clinical cases that demonstrate the necessity of a multimodal strategy in diagnosing and managing prosthetic valve complications.
Tricuspid regurgitation is a relatively common and progressive valvular heart disease that significantly affects quality of life and is associated with high mortalities as severity increases. Multimodality imaging is cru...Tricuspid regurgitation is a relatively common and progressive valvular heart disease that significantly affects quality of life and is associated with high mortalities as severity increases. Multimodality imaging is crucial for diagnosis, detailed assessment of the right heart and tricuspid valve, and selecting the most appropriate treatment strategy. This article reviews currently used imaging modalities-echocardiography, cardiac magnetic resonance, and cardiac computed tomography-and their applicability in clinical practice.
Mitral regurgitation (MR) is a common valvular pathology and is widely known to cause morbidity and mortality. Quantification of MR severity is critical for determining surveillance strategies and to guide timing of proc...Mitral regurgitation (MR) is a common valvular pathology and is widely known to cause morbidity and mortality. Quantification of MR severity is critical for determining surveillance strategies and to guide timing of procedural intervention. There are numerous ways to quantify regurgitant volume, each with their own strengths and weaknesses. In this article, we review multimodality imaging of the mitral valve and explore the most common and widely used imaging modalities and methods to evaluate MR severity.
Thoracic aortic disease involves diverse degenerative, syndromic, and genetic conditions, posing lifelong risks of high morbidity and mortality. Early detection and multimodal imaging are crucial for effective surveillan...Thoracic aortic disease involves diverse degenerative, syndromic, and genetic conditions, posing lifelong risks of high morbidity and mortality. Early detection and multimodal imaging are crucial for effective surveillance and reducing complications. Understanding imaging characteristics and disease-specific features enables personalized management strategies. Emerging research on parameters like aortic length and indexed ratios promises to refine risk assessment and surgical timing beyond traditional size criteria. However, data gaps remain for heterogeneous groups such as hereditary thoracic aortopathies and vascular Ehlers-Danlos syndrome. As medicine advances toward personalized care, a comprehensive framework for multimodal imaging is essential for optimal patient outcomes.