Advertisement

Depression and cardiovascular diseases

  • Tsuyoshi Shiga
    Correspondence
    Department of Clinical Pharmacology and Therapeutics, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
    Affiliations
    Department of Clinical Pharmacology and Therapeutics, The Jikei University School of Medicine, Tokyo, Japan
    Search for articles by this author
Published:December 01, 2022DOI:https://doi.org/10.1016/j.jjcc.2022.11.010

      Highlights

      • Depression is a risk factor for adverse cardiovascular outcomes.
      • Cardiovascular disease and depression share common pathogenic mechanisms.
      • A two-step depression screening protocol using the Patient Health Questionnaire (PHQ)-2 and PHQ-9 is recommended.
      • There is no effective treatment for depression to improve cardiovascular outcomes.
      • A collaborative cross-disciplinary approach is required for the management of depression.

      Abstract

      Depression is a well-known risk factor for adverse cardiovascular outcomes in patients with cardiovascular diseases. The prevalence of depression in patients with cardiovascular diseases has been reported to be approximately 20 %. A two-step depression screening protocol using the 2-item Patient Health Questionnaire (PHQ-2) and the 9-item Patient Health Questionnaire (PHQ-9) is recommended for patients with cardiovascular diseases. Cardiovascular diseases and depression share a common pathology, including increased activity of the sympathetic nervous system, hyperactivity of hypothalamic-pituitary-adrenal axis, and inflammation. Psychosocial and environmental factors are also associated with depression and cardiovascular outcomes. Randomized controlled trials of antidepressant treatment for patients with depression and cardiovascular diseases have shown no advantage regarding cardiovascular outcomes. However, improvement in depressive symptoms, regardless of the method, may lead to a reduction in subsequent cardiovascular events. A collaborative approach between cardiologists and psychiatrists is recommended to manage depression in patients with cardiovascular diseases. Future research should identify more specific targets for treating patients with cardiovascular diseases, involve collaboration with professionals across fields, and establish community support systems.

      Graphical abstract

      Keywords

      Abbreviations:

      AHA (American Heart Association), BDI (Beck Depression Inventory), CAD (Coronary artery disease), CBT (Cognitive-behavioral therapy), CRP (C-reactive protein), HADS (Hospital Anxiety and Depression Scale), HF (Heart Failure), HPA (Hypothalamic-pituitary-adrenal), ICD (Implantable cardioverter defibrillator), IL (Interleukin), MDD (Major depression disorder), PHQ (Patient Health Questionnaire), SADHART-CHF (Sertraline Against Depression and Heart Disease in Chronic Heart Failure), SAM (Sympathetic-adreno-medullar), SDS (Zung Self-Rating Depression Scale)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rozanski A.
        • Blumenthal J.A.
        • Kaplan J.
        Impact of psychological factors on the pathogenesis of cardiovascular disease and implication for therapy.
        Circulation. 1999; 99: 2192-2217
        • Jiang W.
        • Alexander J.
        • Christopher E.J.
        • Kuchibhatla M.
        • Gaulden L.F.
        • Cuffe M.S.
        • et al.
        Relationship of depression to increase risk of mortality and rehospitalization in patients with congestive heart failure.
        Arch Intern Med. 2001; 161: 1849-1856
        • Vaccarino V.
        • Kasl S.
        • Abramson J.
        • Krumhoz H.
        Depressive symptoms and risk of functional decline and death in patients with heart failure.
        J Am Coll Cardiol. 2001; 38: 199-205
        • Carney R.M.
        • Blumenthal J.A.
        • Catellier D.
        • Freedland K.E.
        • Berkman L.F.
        • Watkins L.L.
        • et al.
        Depression as a risk factor for mortality after acute myocardial infarction.
        Am J Cardiol. 2003; 92: 1277-1281
        • Barth J.
        • Schumacher M.
        • Herrmann-Lingen C.
        Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis.
        Psychosom Med. 2004; 66: 802-813
        • Whooley M.A.
        Depression and cardiovascular disease: healing the broken-hearted.
        JAMA. 2006; 295: 2874-2881
        • Nicholson A.
        • Kuper H.
        • Hemingway H.
        Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146538 participants in 54 observational studies.
        Eur Heart J. 2006; 27: 2763-2774
        • Thombs B.D.
        • Bass E.B.
        • Ford D.E.
        • Stewart K.J.
        • Tsilidis K.K.
        • Patel U.
        • et al.
        Prevalence of depression in survivors of acute myocardial infarction. Review of the evidence.
        J Gen Intern Med. 2006; 21: 30-38
        • Rudisch B.
        • Nemeroff C.B.
        Epidemiology of comorbid coronary artery disease and depression.
        Biol Psychiatry. 2003; 54: 227-240
        • Rutledge T.
        • Reis V.A.
        • Linke S.E.
        • Greenberg B.H.
        • Mills P.J.
        Depression in heart failure: a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes.
        J Am Coll Cardiol. 2006; 48: 1527-1537
        • Lesperance F.
        • Frasure-Smith N.
        Depression in patients with cardiac disease: a practical review.
        J Psychosom Res. 2000; 48: 379-391
        • Havranek E.P.
        • Ware M.G.
        • Lowes B.D.
        Prevalence of depression in congestive heart failure.
        Am J Cardiol. 1999; 84: 348-350
        • Guck T.P.
        • Elsasser G.N.
        • Kavan M.G.
        • Barone E.J.
        Depression and congestive heart failure.
        Congest Heart Fail. 2003; 9: 163-169
        • Hare D.L.
        Depression and cardiovascular disease.
        Curr Opin Lipidol. 2021; 32: 167-174
        • Egede L.E.
        Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability.
        Gen Hosp Psychiatry. 2007; 29: 409-416
        • Moullec G.
        • Plourde A.
        • Lavoie K.L.
        • Suarthana E.
        • Bacon S.L.
        Beck depression inventory II: determination and comparison of its diagnostic accuracy in cardiac outpatients.
        Eur J Prev Cardiol. 2015; 22: 665-672
        • Suzuki T.
        • Shiga T.
        • Kuwahara K.
        • Kobayashi S.
        • Suzuki S.
        • Nishimura K.
        • et al.
        Depression and outcomes in hospitalized Japanese patients with cardiovascular disease-prospective single-center observational study.
        Circ J. 2011; 75: 2465-2473
        • Suzuki T.
        • Shiga T.
        • Omori H.
        • Tatsumi F.
        • Nishimura K.
        • Hagiwara N.
        Depression and outcomes in Japanese outpatients with cardiovascular disease - a prospective observational study.
        Circ J. 2016; 80: 2482-2488
        • Kato N.
        • Kinugawa K.
        • Yao A.
        • Hatano M.
        • Shiga T.
        • Kazuma K.
        Relationship of depressive symptoms with hospitalization and death in Japanese patients with heart failure.
        J Card Fail. 2009; 15: 912-919
        • Shimizu Y.
        • Yamada S.
        • Miyake F.
        • Izumi T.
        • PTMaTCH Collaborators
        The effects of depression on the course of functional limitations in patients with chronic heart failure.
        J Cardiac Fail. 2011; 17: 503-510
        • Sears S.F.
        • Conti J.B.
        Quality of life and psychological functioning of ICD patients.
        Heart. 2002; 87: 488-493
        • Suzuki T.
        • Shiga T.
        • Kuwahara K.
        • Kobayashi S.
        • Suzuki S.
        • Nishimura K.
        • et al.
        Prevalence and persistence of depression in patients with implantable cardioverter defibrillator: a 2-year longitudinal study.
        Pacing Clin Electrophysiol. 2010; 33: 1455-1461
        • Bilge A.K.
        • Ozben B.
        • Demircan S.
        • Cinar M.
        • Yilmaz E.
        • Adalet K.
        Depression and anxiety status of patients with implantable cardioverter defibrillator and precipitating factors.
        Pacing Clin Electrophysiol. 2006; 29: 619-626
        • Friedmann S.
        • Thomas S.A.
        • Inguito P.
        • Kao C.W.
        • Metcalf M.
        • Kelley F.J.
        • et al.
        Quality of life and psychological status of patients with implantable cardioverter defibrillators.
        J Interv Card Electrophysiol. 2006; 17: 65-72
        • Lichtman J.H.
        • Bigger Jr., J.T.
        • Blumenthal J.A.
        • Frasure-Smith N.
        • Kaufmann P.G.
        • Lespérance F.
        • et al.
        Depression and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association.
        Circulation. 2008; 118: 1768-1775
        • American Psychiatry Association
        Diagnostic and statistical manual of mental disorders.
        5th Edition. American Psychiatric Association, Washington, DC2013
        • Piepenburg S.M.
        • Faller H.
        • Gelbrich G.
        • Störk S.
        • Warrings B.
        • Ertl G.
        • et al.
        Comparative potential of the 2-item versus the 9-item patient health questionnaire to predict death or rehospitalization in heart failure.
        Circ Heart Fail. 2015; 8: 464-472
        • Suzuki T.
        • Shiga T.
        • Nishimura K.
        • Omori H.
        • Tatsumi F.
        • Hagiwara N.
        Patient health questionnaire-2 screening for depressive symptoms in Japanese outpatients with heart failure.
        Intern Med. 2019; 58: 1689-1694
        • Ladwig K.H.
        • Kieser M.
        • König M.
        • Breithardt G.
        • Borggrefe M.
        Affective disorders and survival after acute myocardial infarction: results from the post-infarction late potential study.
        Eur Heart J. 1991; 12: 959-964
        • Frasure-Smith N.
        • Lespérance F.
        • Talajic M.
        Depression following myocardial infarction: impact on 6-month survival.
        JAMA. 1993; 270: 1819-1825
        • Frasure-Smith N.
        • Lespérance F.
        • Talajic M.
        Depression and 18-month prognosis after myocardial infarction.
        Circulation. 1995; 91: 999-1005
        • Barefoot J.C.
        • Helms M.J.
        • Mark D.B.
        • Blumenthal J.A.
        • Califf R.M.
        • Haney T.L.
        • et al.
        Depression and long-term mortality risk in patients with coronary artery disease.
        Am J Cardiol. 1996; 78: 613-617
        • Lespérance F.
        • Frasure-Smith N.
        • Juneau M.
        • Théroux P.
        Depression and 1-year prognosis in unstable angina.
        Arch Intern Med. 2000; 160: 1354-1360
        • Lespérance F.
        • Frasure-Smith N.
        • Talajic M.
        • Bourassa M.G.
        Five-year risk of cardiac mortality in relation to initial severity and one-year changes in depression symptoms after myocardial infarction.
        Circulation. 2002; 105: 1049-1053
        • Nakamura S.
        • Kato K.
        • Yoshida A.
        • Fukuma N.
        • Okumura Y.
        • Ito H.
        • et al.
        Prognostic value of depression, anxiety, and anger in hospitalized cardiovascular disease patients for predicting adverse cardiac outcomes.
        Am J Cardiol. 2013; 111: 1432-1436
        • Nicholson A.
        • Kuper H.
        • Hemingway H.
        Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies.
        Eur Heart J. 2006; 27: 2763-2774
        • Gan Y.
        • Gong Y.
        • Tong X.
        • Sun H.
        • Cong Y.
        • Dong X.
        • et al.
        Depression and the risk of coronary heart disease: a meta-analysis of prospective cohort studies.
        BMC Psychiatry. 2014; 14: 371
        • Shi S.
        • Liu T.
        • Liang J.
        • Hu D.
        • Yang B.
        Depression and risk of sudden cardiac death and arrhythmias: a meta-analysis.
        Psychosom Med. 2017; 79: 153-161
        • Whang W.
        • Albert C.M.
        • Sears S.F.
        • Lampert R.
        • Conti J.B.
        • Wang P.J.
        • et al.
        Depression as a predictor for appropriate shocks among patients with implantable cardioverter-defibrillators: results from the Triggers of Ventricular Arrhythmias (TOVA) study.
        J Am Coll Cardiol. 2005; 45: 1090-1095
        • Hegel M.T.
        • Griegel L.E.
        • Black C.
        • Goulden L.
        • Ozahowski T.
        Anxiety and depression in patients receiving implanted cardioverter-defibrillators: a longitudinal investigation.
        Int J Psychiatry Med. 1997; 27: 57-69
        • Kamphuis H.C.M.
        • de Leeuw J.R.J.
        • Derksen R.
        • Hauer R.N.W.
        • Winnubst J.A.M.
        Implantable cardioverter defibrillator recipients: quality of life in recipients with and without ICD shock delivery.
        Europace. 2003; 5: 381-389
        • Doris A.
        • Ebmeier K.
        • Shajahan P.
        Depressive illness.
        Lancet. 1999; 354: 1369-1375
        • Kessler R.C.
        • Berglund P.
        • Demler O.
        • Jin R.
        • Koretz D.
        • Merikangas K.R.
        • et al.
        The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCSR).
        JAMA. 2003; 289: 3095-3105
        • Rahmawati A.
        • Chishaki A.
        • Sawatari H.
        • Tsuchihashi-Makaya M.
        • Ohtsuka Y.
        • Nakai M.
        • et al.
        Gender disparities in quality of life and psychological disturbance in patients with implantable cardioverter-defibrillators.
        Circ J. 2013; 77: 1158-1165
        • Libby P.
        • Loscalzo J.
        • Ridker P.M.
        • Farkouh M.E.
        • Hsue P.Y.
        • Fuster V.
        • et al.
        Inflammation, immunity, and infection in atherothrombosis: JACC review topic of the week.
        J Am Coll Cardiol. 2018; 72: 2071-2081
        • Danesh J.
        • Collins R.
        • Appleby P.
        • Peto R.
        Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies.
        JAMA. 1998; 279: 1477-1482
        • Ridker P.M.
        • Hennekens C.H.
        • Buring J.E.
        • Rifai N.
        C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women.
        N Engl J Med. 2000; 342: 836-843
        • Ridker P.M.
        • Rifai N.
        • Rose L.
        • Buring J.E.
        • Cook N.R.
        Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events.
        N Engl J Med. 2002; 347: 1557-1565
        • Speer T.
        • Dimmeler S.
        • Schunk S.J.
        • Fliser D.
        • Ridker P.M.
        Targeting innate immunity-driven inflammation in CKD and cardiovascular disease.
        Nat Rev Nephrol. 2022; 18: 762-778https://doi.org/10.1038/s41581-022-00621-9
        • Howren M.B.
        • Lamkin D.M.
        • Suls J.
        Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis.
        Psychosom Med. 2009; 71: 171-186
        • Khandaker G.M.
        • Zuber V.
        • Rees J.M.B.
        • Carvalho L.
        • Mason A.M.
        • Foley C.N.
        • et al.
        Shared mechanisms between coronary heart disease and depression: findings from a large UK general population-based cohort.
        Mol Psychiatry. 2020; 25: 1477-1486
        • Nater U.M.
        • Skoluda N.
        • Strahler J.
        Biomarkers of stress in behavioural medicine.
        Curr Opin Psychiatry. 2013; 26: 440-445
        • Shimbo D.
        • Chaplin W.
        • Crossman D.
        • Haas D.
        • Davidson K.W.
        Role of depression and inflammation in incident coronary heart disease events.
        Am J Cardiol. 2005; 96: 1016-1021
        • Duivis H.E.
        • de Jonge P.
        • Penninx B.W.
        • Na B.Y.
        • Cohen B.E.
        • Whooley M.A.
        Depressive symptoms, health behaviors, and subsequent inflammation in patients with coronary heart disease: prospective findings from the heart and soul study.
        Am J Psychiatry. 2011; 168: 913-920
        • Levine S.P.
        • Towell B.L.
        • Suarez A.M.
        • Knieriem L.K.
        • Harris M.M.
        • George J.N.
        Platelet activation and secretion associated with emotional stress.
        Circulation. 1985; 71: 1129-1134
        • Koudouovoh-Tripp P.
        • Hüfner K.
        • Egeter J.
        • Kandler C.
        • Giesinger J.M.
        • Sopper S.
        • et al.
        Stress enhances proinflammatory platelet activity: the impact of acute and chronic mental stress.
        J Neuroimmune Pharmacol. 2021; 16: 500-512
        • Serebruany V.L.
        • Glassman A.H.
        • Malinin A.I.
        • Sane D.C.
        • Finkel M.S.
        • Krishnan R.R.
        • et al.
        Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes: evidence from recent clinical trials.
        Blood Coagul Fibrinolysis. 2003; 14: 563-567
        • Gold P.W.
        • Goodwin F.K.
        • Chrousos G.P.
        Clinical and biochemical manifestations of depression. Relation to the neurobiology of stress (1).
        N Engl J Med. 1988; 319: 348-353
        • Shao M.
        • Lin X.
        • Jiang D.
        • Tian H.
        • Xu Y.
        • Wang L.
        • et al.
        Depression and cardiovascular disease: shared molecular mechanisms and clinical implications.
        Psychiatry Res. 2020; 285112802
        • Cowen P.J.
        Not fade away: the HPA axis and depression.
        Psychol Med. 2010; 40: 1-4
        • Joseph D.N.
        • Whirledge S.
        Stress and the HPA axis: balancing homeostasis and fertility.
        Int J Mol Sci. 2017; 18: 2224
        • Cohen S.
        • Janicki-Deverts D.
        • Doyle W.J.
        • Miller G.E.
        • Frank E.
        • Rabin B.S.
        • et al.
        Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk.
        Proc Natl Acad Sci U S A. 2012; 109: 5995-5999
        • Burford N.G.
        • Webster N.A.
        • Cruz-Topete D.
        Hypothalamic-pituitary-adrenal axis modulation of glucocorticoids in the cardiovascular system.
        Int J Mol Sci. 2017; 18: 2150
        • Kim Y.H.
        • Kim S.H.
        • Lim S.Y.
        • Cho G.Y.
        • Baik I.K.
        • Lim H.E.
        • et al.
        Relationship between depression and subclinical left ventricular changes in the general population.
        Heart. 2012; 98: 1378-1383
        • Udupa K.
        • Sathyaprabha T.N.
        • Thirthalli J.
        • Kishore K.R.
        • Lavekar G.S.
        • Raju T.R.
        • et al.
        Alteration of cardiac autonomic functions in patients with major depression: a study using heart rate variability measures.
        J Affect Disord. 2007; 100: 137-141
        • Koschke M.
        • Boettger M.K.
        • Schulz S.
        • Berger S.
        • Terhaar J.
        • Voss A.
        • et al.
        Autonomy of autonomic dysfunction in major depression.
        Psychosom Med. 2009; 71: 852-860
        • Powell-Wiley T.M.
        • Baumer Y.
        • Baah F.O.
        • Baez A.S.
        • Farmer N.
        • Mahlobo C.T.
        • et al.
        Social determinants of cardiovascular disease.
        Circ Res. 2022; 130: 782-799
        • DiMatteo M.R.
        • Lepper H.S.
        • Groghan T.W.
        Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence.
        Arch Intern Med. 2000; 160: 2101-2107
        • Van der Wal M.H.L.
        • Jaarsma T.
        • Moser D.K.
        • Veeger N.J.
        • van Gilst W.H.
        • van Veldhuisen D.J.
        Compliance in heart failure patients: the importance of knowledge and beliefs.
        Eur Heart J. 2006; 27: 434-440
        • Tsuchihashi-Makaya M.
        • Kato N.
        • Chishaki A.
        • Takeshita A.
        • Tsutsui H.
        Anxiety and poor social support are independently associated with adverse outcomes in patients with mild heart failure.
        Circ J. 2009; 73: 280-287
        • Friedmann E.
        • Son H.
        • Thomas S.A.
        • Chapa D.W.
        • Lee H.J.
        on behalf of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Poor social support is associated with increases in depression but not anxiety over 2 years in heart failure outpatients.
        J Cardiovasc Nurs. 2014; 29: 20-28
        • Dar T.
        • Radfar A.
        • Abohashem S.
        • Pitman R.K.
        • Tawakol A.
        • Osborne M.T.
        Psychosocial stress and cardiovascular disease.
        Curr Treat Options Cardiovasc Med. 2019; 21: 23
        • National Institute for Health and Care Excellence
        Clinical guideline [CG91]: Depression in adults with a chronic physical health problem: recognition and management.
        • Anzai T.
        • Sato T.
        • Fukumoto Y.
        • Izumi C.
        • Kizawa Y.
        • Koga M.
        • et al.
        JCS/JHFS 2021 statement on palliative care in cardiovascular diseases.
        Circ J. 2021; 85: 695-757
        • Gottlieb S.S.
        • Kop W.J.
        • Thomas S.A.
        • Katzen S.
        • Vesely M.R.
        • Greenberg N.
        • et al.
        A double-blind placebo-controlled pilot study of controlled-release paroxetine on depression and quality of life in chronic heart failure.
        Am Heart J. 2007; 153: 868-873
        • Lespérance F.
        • Frasure-Smith N.
        • Laliberté M.A.
        • White M.
        • Lafontaine S.
        • Calderone A.
        • et al.
        An open-label study of nefazodone treatment of major depression in patients with congestive heart failure.
        Can J Psychiatry. 2003; 48: 695-701
        • Berkman L.F.
        • Blumenthal J.
        • Burg M.
        • Carney R.M.
        • Catellier D.
        • Cowan M.J.
        • et al.
        Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial.
        JAMA. 2003; 289: 3106-3116
        • O'Connor C.M.
        • Jiang W.
        • Kuchibhatla M.
        • Silva S.G.
        • Cuffe M.S.
        • Callwood D.D.
        • et al.
        Safety and efficacy of sertraline for depression in patients with heart failure: results of the SADHART-CHF (Sertraline Against Depression and Heart Disease in Chronic Heart Failure) trial.
        J Am Coll Cardiol. 2010; 56: 692-699
        • Jiang W.
        • Krishnan R.
        • Kuchibhatla M.
        • Cuffe M.S.
        • Martsberger C.
        • Arias R.M.
        • et al.
        Characteristics of depression remission and its relation with cardiovascular outcome among patients with chronic heart failure (from the SADHART-CHF Study).
        Am J Cardiol. 2011; 107: 545-551
        • Shiga T.
        • Suzuki T.
        • Nishimura K.
        Psychological distress in patients with an implantable cardioverter defibrillator.
        J Arrhythm. 2013; 29: 310-313
        • Hirschfeld R.M.
        The epidemiology of depression and the evolution of treatment.
        J Clin Psychiatry. 2012; 73: 5-9
        • Jeyanantham K.
        • Kotecha D.
        • Thanki D.
        • Dekker R.
        • Lane D.A.
        Effects of cognitive behavioural therapy for depression in heart failure patients: a systematic review and meta-analysis.
        Heart Fail Rev. 2017; 22: 731-741
        • Kohn C.S.
        • Petrucci R.J.
        • Baessier C.
        • Soto D.M.
        • Movsowitz C.
        The effect of psychological intervention on patients' long-term adjustment to the ICD: a prospective study.
        Pacing Clin Electrophysiol. 2000; 23: 450-456
        • Chevalier P.
        • Cottraux J.
        • Mollard E.
        • Sai N.
        • Brun S.
        • Burri H.
        • et al.
        Prevention of implantable defibrillator shocks by cognitive behavioral therapy: a pilot trial.
        Am Heart J. 2006; 151: 191.e1-191.e6
        • Suzuki S.
        • Takaki H.
        • Yasumura Y.
        • Sakuragi S.
        • Takagi S.
        • Tsutsumi Y.
        • et al.
        Assessment of quality of life with 5 different scales in patients participating in comprehensive cardiac rehabilitation after acute myocardial infarction.
        Circ J. 2005; 69: 1527-1534
        • Tu R.H.
        • Zeng Z.Y.
        • Zhong G.Q.
        • Wu W.F.
        • Lu Y.J.
        • Bo Z.D.
        • et al.
        Effects of exercise training on depression in patients with heart failure: a systematic review and meta-analysis of randomized controlled trials.
        Eur J Heart Fail. 2014; 16: 749-757
        • Zheng X.
        • Zheng Y.
        • Ma J.
        • Zhang M.
        • Zhang Y.
        • Liu X.
        • et al.
        Effect of exercise-based cardiac rehabilitation on anxiety and depression in patients with myocardial infarction: a systematic review and meta-analysis.
        Heart Lung. 2019; 48: 1-7
        • Vaccarino V.
        • Badimon L.
        • Bremner J.D.
        • Cenko E.
        • Cubedo J.
        • Dorobantu M.
        • et al.
        Depression and coronary heart disease: 2018 position paper of the ESC working group on coronary pathophysiology and microcirculation.
        Eur Heart J. 2020; 41: 1687-1696
        • Ladwig K.H.
        • Baghai T.C.
        • Doyle F.
        • Hamer M.
        • Herrmann-Lingen C.
        • Kunschitz E.
        • et al.
        Mental health-related risk factors and interventions in patients with heart failure: a position paper endorsed by the European Association of Preventive Cardiology (EAPC).
        Eur J Prev Cardiol. 2022; 29: 1124-1141
        • Kuwabara M.
        • Mori M.
        • Komoto S.
        Japanese national plan for promotion of measures against cerebrovascular and cardiovascular disease.
        Circulation. 2021; 143: 1929-1931