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Mind and body interventions in cardiology

The importance of the brain–heart connection

Mind-Body-Interventionen in der Kardiologie

Bedeutung der Hirn-Herz-Achse

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Abstract

Mind and body interventions aim to harness the “relaxation response”, reduce stress, and improve quality of life, which is important in the search for more holistic treatment approaches in cardiovascular medicine. This article describes the pertinent pathophysiological correlates building the mechanistic backbone for these interventions. They can be found in the complex connections of brain and heart (central and autonomic nervous system, hypothalamic–pituitary–adrenal axis), which play an important role in the development of various cardiovascular disease conditions and hold potential as therapeutic targets. The evidence regarding the effect of mind and body interventions in cardiology with a focus on arrhythmia and psychocardiology is reviewed systematically. To date, mostly small pilot studies prone to substantial bias and without adequate power have dominated the field and longer-term outcome data are lacking. Ultimately, integration of mind and body interventions could empower patients by strengthening their individual responsibility and mental power in addition to the benefits of stress reduction and improvement of quality of life. Whether this will translate into relevant longer-term clinical outcomes remains uncertain. Therefore, this field offers multifaceted opportunities for further research and practical applications.

Zusammenfassung

Mind-Body-Interventionen, wie beispielsweise die Meditation, bezwecken eine Entspannung von Geist und Körper zu bewirken, Stress zu reduzieren und die Lebensqualität zu verbessern. Auf der Suche nach ganzheitlichen Therapieansätzen in der kardiovaskulären Medizin sind diese Aspekte von Wichtigkeit. Im vorliegenden Artikel werden die relevanten pathophysiologischen Korrelate, die die Basis für die Wirkung solcher Interventionen bilden, beschrieben. Diese spiegeln sich in den komplexen Verbindungen zwischen Hirn und Herz wider, welche eine wichtige Rolle in der Entstehung verschiedener kardiovaskulärer Erkrankungen spielen und zugleich ein Potenzial für Therapieansätze bieten. Des Weiteren wird die Evidenz hinsichtlich der Effekte von Mind-Body-Interventionen im Bereich der Kardiologie mit Fokus auf Rhythmologie und Psychokardiologie nach systematischer Literaturrecherche dargestellt. Allerdings sind diesem Bereich zumeist nur kleine Studien mit z. T. kurzem Follow-up verfügbar, bei denen von einem erheblichen Bias ausgegangen werden muss. Durch die Integration von Mind-Body-Interventionen in die kardiologische/rhythmologische Versorgung können, über die stressreduzierenden und die Lebensqualität verbessernden Aspekte hinaus, Eigenverantwortung und die mentale Kraft der Patienten gestärkt werden. Ob sich dies dann auch langfristig in relevante klinische Endpunkte umsetzen lässt, bleibt bisher unklar. Dieses Gebiet eröffnet vielseitige Möglichkeiten für Forschung und klinische Anwendung.

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Authors and Affiliations

  1. Abteilung für Rhythmologie, Herzzentrum Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany

    Julia Lurz MD

  2. Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Karl-Heinz Ladwig MD, PhD

  3. German Centre for Cardiovascular Research (DZHK), Partner site Munich Heart Alliance, Munich, Germany

    Karl-Heinz Ladwig MD, PhD

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  1. Julia Lurz MD
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Correspondence to Julia Lurz MD.

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J. Lurz and K.-H. Ladwig declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Lurz, J., Ladwig, KH. Mind and body interventions in cardiology. Herz 47, 103–109 (2022). https://doi.org/10.1007/s00059-022-05104-y

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