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Psycho-Cardiological Disease studies the complex links between the cardiovascular system and emotions. The two diseases are now the focus of public health organizations, forming a vicious circle of mutual influence. Anxiety and depressive symptoms are three to four times more common in patients with cardiovascular disease than in the general population, and about 15 to 18 percent of patients with coronary heart disease also have major depression, while 25 to 30 percent show significant depressive symptoms. At least 20% of patients with chronic heart failure have some degree of depression. In addition, the probability of cardiovascular events is 2.5 times higher in patients with two hearts, the risk of recurrence of cardiovascular events is heightened, and is strongly associated with higher mortality. At present, the common treatment methods show different advantages and disadvantages, for example, Antipsychotics treatment is a common means of depression/anxiety symptoms, with rapid onset, significant efficacy, wide application and other advantages. However, medications often struggle to fully relieve symptoms, have a high recurrence rate, and can have side effects. Psychotherapy as a traditional intervention method for mental disorders. Its advantages are long-lasting efficacy and no Antipsychotics dependence, but the effect is slower, and patients need to invest more time, energy and financial resources, and the psychological burden is also heavier. In recent years, exercise therapy, as a safe intervention without significant side effects, has been gradually included in a number of international clinical guidelines, and is regarded as the first-line recommended treatment for mild to moderate depression. Research has shown that exercise can effectively relieve anxiety and depression symptoms through a variety of mechanisms, such as lowering cortisol levels, regulating autonomic nervous system function, and reducing stress responses. A study of aerobic exercise in patients with Psycho-Cardiological Disease showed that a 16-week exercise intervention significantly reduced patients' depression scores and significantly improved mood and cognitive function. In addition, it has been validated in multiple studies that exercise can significantly reduce anxiety and depression symptoms by enhancing neuroplasticity, promoting neurogenesis and synaptic remodeling, improving cognitive and emotional regulation. These findings provide a strong theoretical and practical basis for the application of exercise therapy in the comprehensive management of Psycho-Cardiological Disease. The above studies provide important theoretical support for the treatment of biheart disease with exercise, but most studies focus on scale scores, biomarkers, and changes in social behavior. It is well known that antidepressant or anti-anxiety drugs can have many side effects due to their dosage, duration and long-term use, which in turn poses a potential risk to the overall health and quality of life of patients. Therefore, it is of significant clinical significance and research value to explore whether exercise as an adjunct therapy can effectively reduce the use of Antipsychotics and shorten the withdrawal period. This will not only help optimize personalized treatment plans, provide scientific basis for clinical decision-making, but also promote the development of Psycho-Cardiological Disease treatment to the direction of precision and integration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exercise and medicine | Active Comparator | Exercise:Moderate-intensity continuous movement(MICT) The drugs include: sertraline, escitalopram, fluoxetine, duloxetine, paroxetine, venlafaxine, and fluvoxamine |
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| medicine | Active Comparator | The drugs include: sertraline, escitalopram, fluoxetine, duloxetine, paroxetine, venlafaxine, and fluvoxamine |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Moderate-intensity continuous movement and Antipsychotics intervention | Behavioral | On the basis of Antipsychotics intervention, Patients in the exercise group should start exercise intervention as soon as possible after completing baseline examination, and need to complete a training plan of at least 36 times, 3 times/week. At the beginning of each training session, patients need to warm up for 5-10 minutes, mainly jogging and stretching exercises. After the warm-up, the patient enters the training phase, the heart rate reserve is 70% to 85%, and after the training, the patient performs 10-15 minutes of recovery exercise, mainly jogging, slow walking and stretching. The specific exercise plan is formulated according to the patients' own aerobic capacity assessment, and the principle of formulation is gradual and individual. At each training session, patients were asked about their perceived fatigue level to adjust the training intensity. |
| Measure | Description | Time Frame |
|---|---|---|
| Dosage of anti-anxiety/depression drugs | The proportion of patients with cardiovascular diseases complicated with anxiety and depression who received a 50% reduction in the dosage of anti-anxiety/depression drugs | Baseline and after 12 weeks of intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Hamilton Depression and Anxiety Scale (HAMD, HAMA) | HAMD:0-76 points; HAMA: 0-56 points The higher the score is, the worse the result will be | Baseline and at the end of the intervention (Week 12), 1 month, 6 months, 1 year and 2 years after the end of the intervention |
| Perceived Stress Scale (PSS) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Huan Ha, PhD | Contact | +86 15078755932 | mahuandoctor@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Guangdong Provincial People's Hospital | Recruiting | Guangzhou | Guangdong | 510080 | China |
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| Antipsychotics intervention(sertraline, escitalopram, fluoxetine, duloxetine, paroxetine, venlafaxine, and fluvoxamine) | Drug | Patients maintained regular medication during the intervention period, and returned to the doctor every two weeks, and the psychiatrist decided whether to maintain the current dose or gradually reduce the dose based on the patient's symptoms and diagnosis. Psychiatrists, unaware of patient groupings, use supportive measures to help manage adverse reactions. |
|
PSS: 0-40 points The higher the score is, the worse the result will be |
| Baseline and at the end of the intervention (Week 12), 1 month, 6 months, 1 year and 2 years after the end of the intervention |
| Pittsburgh Sleep Quality Index (PSQI) | PSQI: 0-21 points the higher the score, the worse the result. | Baseline and at the end of the intervention (Week 12), 1 month, 6 months, 1 year and 2 years after the end of the intervention |
| 12-Item Short Form Health Survey(SF-12) | SF-12:0-100 points. The higher the score, the better the health condition | Baseline and at the end of the intervention (Week 12), 1 month, 6 months, 1 year and 2 years after the end of the intervention |
| Discontinuation Emergent Symptoms and Signs Scale(DESS) | The more new symptoms emerge, the more severe the adverse reactions of drug withdrawal will be. | Baseline and at the end of the intervention (Week 12), 1 month, 6 months, 1 year and 2 years after the end of the intervention |
| Cardiopulmonary exercise test(CPET) | Baseline and at the end of the intervention (Week 12), one month after the end of the intervention |
| The recurrence rate of anxiety/depression | Baseline and one month, six months, one year and two years after the intervention ended |
| Electrocardiogram | Evaluate QTc | Baseline and at the end of the intervention (Week 12), one month after the end of the intervention |
| Blood test | Liver function, seven items of blood lipid, two items of myocardial function, blood routine, biochemical indicators | Baseline and at the end of the intervention (Week 12) |
| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D000089983 | Escitalopram |
| D005473 | Fluoxetine |
| D000068736 | Duloxetine Hydrochloride |
| D017374 | Paroxetine |
| D000069470 | Venlafaxine Hydrochloride |
| D016666 | Fluvoxamine |
| ID | Term |
|---|---|
| D011437 | Propylamines |
| D000588 | Amines |
| D009930 | Organic Chemicals |
| D009570 | Nitriles |
| D001572 | Benzofurans |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D013876 | Thiophenes |
| D013457 | Sulfur Compounds |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D010880 | Piperidines |
| D003511 | Cyclohexanols |
| D000441 | Hexanols |
| D005233 | Fatty Alcohols |
| D000438 | Alcohols |
| D010627 | Phenethylamines |
| D005021 | Ethylamines |
| D003510 | Cyclohexanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D008055 | Lipids |
| D010091 | Oximes |
| D006898 | Hydroxylamines |
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