CONGRESS ABSTRACT

Background: Psychological distress is common after cardiac interventions and may adversely affect recovery and long-term prognosis. However, data on the longitudinal evolution of anxiety, depression, and mood during structured cardiac rehabilitation (CR), and across different cardiac diagnoses, remain limited. Methods: In this prospective observational study, 171 patients admitted to a one-year CR program after cardiac intervention were evaluated at baseline, 6 months, and 12 months. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), while positive mood was evaluated using the Global Mood Scale (GMS, Positive Affect subscale). Longitudinal changes were analysed using linear mixed-effects models with time as a fixed effect and patient as a random intercept. Both unadjusted models and models adjusted for age, sex, body mass index, and baseline functional capacity (Incremental Shuttle Walk Test) were performed. Interaction terms were used to explore differences between coronary artery disease (CAD) and valvular heart disease (VHD). Results: At baseline, mean HADS-Anxiety was 5.7±4.1 and HADS-Depression was 4.4±3.3, with a mean GMS score of 22.8±. Anxiety significantly decreased at 6 months (Δ −0.84, 95% CI −1.35 to −0.32; p=0.002) and remained reduced at 12 months (Δ −0.80, 95% CI −1.35 to −0.26; p=0.004). Depressive symptoms showed a progressive reduction at 6 months (Δ −0.78, 95% CI −1.23 to −0.34; p=0.001) and 12 months (Δ −1.08, 95% CI −1.55 to −0.61; p<0.001). In parallel, positive mood significantly improved at 6 months (Δ +2.38, 95% CI 1.26 to 3.51; p<0.001) and was maintained at 12 months (Δ +2.47, 95% CI 1.29 to 3.64; p<0.001). These changes remained significant after multivariable adjustment. No significant time-by-diagnosis interaction was observed for anxiety, depression, or mood, indicating similar psychological recovery patterns in CAD and VHD patients. Conclusions: Participation in a structured cardiac rehabilitation program was associated with significant improvements in both anxiety and depression, accompanied by a sustained enhancement of positive mood. These benefits appear consistent across different cardiac diagnoses and independent of baseline functional capacity. The findings support the integration of systematic psychological assessment and support within comprehensive cardiac rehabilitation programs.