Stress is recognized as a significant trigger and exacerbator of various medical conditions, particularly in the field of cardiovascular disease (CVD). Given that heart rate variability (HRV) offers insight into the functioning of the autonomic nervous system and has been identified as a predictive factor for increased cardiovascular mortality, exploring the correlation between stress and HRV is pertinent. We systematically reviewed trials where researchers investigated the effects of stress-reducing interventions on biomarkers and time-domain/frequency-domain parameters of HRV in CVD. Eligible studies underwent meta-analysis utilizing a random-effects model. The meta-analysis showed overall beneficial effects of stress-reducing interventions on HRV for the standard deviation of Normal-to-Normal intervals (SDNN) in short-term and 24 h assessments, as well as for the low-frequency power (LF) in short-term assessment. Overall effect sizes were notably high and showed significant p-values (short-term SDNN: MD = 6.43, p = 0.01; 24 h SDNN: MD = 10.92, p = 0.004; short-term LF: MD = 160.11, p < 0.001). Our findings highlight the significant impact of stress-reducing interventions in modulating HRV by influencing short-term SDNN and LF parameters, as well as the 24 h assessment of SDNN. These results emphasize the importance of stress-reducing measures in lowering the risk of further progression in CVD and improving patient outcomes.

Background: Chronic stress is a critical factor influencing both physical and mental health. It can weaken the immune system, affect cardiovascular health, and lower quality of life, often leading to psychological disorders like anxiety and depression. Objective: This study aims to evaluate the effectiveness of eHealth stress management interventions on psychological health parameters, specifically anxiety, depression, stress, and quality of life in patients with cardiovascular disease (CVD). Methods: A comprehensive search was conducted across several databases, including the Cochrane Library, APA PsycInfo, Web of Science, PubMed, Embase, and clinical trial registers. Randomized controlled trials assessing the impact of eHealth stress management interventions, namely internet-based cognitive behavioral therapy (CBT), telephone-delivered CBT, internet-based stress management training, or telephone-delivered stress management training, on the specified psychological outcomes in patients with CVD were included. The control group comprised no intervention, a waitlist, (enhanced) usual care, or a web-based intervention not focusing on stress management. To evaluate potential bias, the Risk-of-Bias 2 tool was applied. A random-effects meta-analysis was performed using standard mean difference (SMD) as the effect size, with a sensitivity analysis using mean difference (MD). Results: A total of 6 randomized controlled studies were considered in the meta-analysis. In 5 studies internet-based CBT interventions were examined, while one study used an eHealth intervention based on a CBT approach. The control groups received either usual care, were placed on a waitlist, or participated in a web-based discussion forum. After the intervention period, which ranged from 8 weeks to 6 months, a significant reduction in depressive symptoms (SMD=−0.46, MD=−2.33; P<.001), as assessed by the Patient Health Questionnaire-9, was observed in the intervention group compared with the control group. Mental health–related quality of life, assessed by the subscale of the 12-Item Short-Form Health Survey, showed significant improvement (SMD=0.38, MD=3.89; P<.001) in the intervention group in comparison to the control group following the intervention period. Conclusions: The meta-analysis demonstrates that eHealth stress management interventions substantially improve psychological health parameters in patients with CVD. Given the significant positive impact, health care providers should consider integrating eHealth stress management programs into standard care for patients with CVD. These programs can be a valuable tool in mitigating the psychological burdens associated with chronic cardiovascular conditions, ultimately improving overall patient outcomes and quality of life.

Background: Cardiovascular diseases (CVDs) are the leading causes of death globally. Managing risk factors and preventing atherosclerosis and its progress, especially with lifestyle changes, are highly important. Smartphone-based mobile health (mHealth) strategies allow easily accessible assistance for healthy nutrition. This study aimed to assess the acceptance and outline the needs and demands for a nutritional mHealth tool by analyzing the desired characteristics. Methods: A cross-sectional study was conducted between August 2022 and September 2023 targeting 398 individuals with atherosclerosis. Acceptance, needs, and demands regarding mHealth, sociodemographic, medical, psychometric, and electronic health (eHealth) data were assessed. Multiple hierarchical regression analyses were conducted to determine the predictors of acceptance. Results: High acceptance for nutritional mHealth was reported by 88.4% (n = 274). Significant predictors of acceptance were age (β = −0.01, p = 0.002), diabetes (β = 0.20, p = 0.041), depressive symptoms (β = −0.02, p = 0.017), digital confidence (β = 0.17, p = 0.001), Internet anxiety (β = −0.18, p = 0.004), and the Unified Theory of Acceptance and Use of Technology (UTAUT) predictors effort expectancy (β = 0.23, p < 0.001) and social influence (β = 0.53, p < 0.001). Preferences included handheld devices, permanent use (86.5%), and weekly (44.5%) new content of 10 to 30 min (79%). Conclusions: These results summarize the patients’ preferences for individualized mHealth tools to ensure their effectiveness. Especially regarding the secondary prevention of CVDs, mHealth can be a helpful resource. The high acceptance rate and specific preferences outlined in this study form a strong basis for the development of mHealth tools with a focus on nutritional support in patients with CVDs.

Chronic type B aortic dissection (cTBAD) is a rare but challenging condition that requires individual treatment strategies. Especially the long-term therapy impacts prognosis. In this single-center retrospective study, we evaluated patients with cTBAD in our vascular outpatient clinic over 10 years. Follow-up consultations included contrast-enhanced, electrocardiogram-triggered, high-resolution CT angiography (CTA) covering the entire aorta. Evaluated characteristics went beyond demographic characteristics combining the treatment approach and the timing and occurrence of potential complications. We analyzed 133 patients in total (n = 92, 69.2% male) with cTBAD with a mean follow-up of 67.7 months. Most of them underwent invasive treatment (n = 102, 76.7%), the majority received thoracic endovascular aortic repair (TEVAR) (n = 82, 61.7%). A total of 80 patients (60.2%) had major complications, whereas over a third was free of complications even after 5 years. Most common complications were progress of dissection and endoleaks, aneurysms of true (TL) and false lumen (FL) were more common in the later time periods. The treatment of cTBAD in terms of timing, therapy approach, and complications is still challenging for the entire aortic team. Nevertheless, the early recognition of complications permits promising treatment options and highlights the importance of frequent follow-up examinations especially within the first years.