Research Progress on the Potential Mechanisms and Multimodal Management of Psychocardiological Disease

Cardiovascular disease frequently coexists with anxiety and depression, creating a complex bidirectional relationship between mental and cardiovascular health. Anxiety and depression may increase cardiovascular risk, impair treatment adherence and self-management, and contribute to poorer long-term outcomes. Conversely, acute cardiovascular events, persistent physical symptoms, and functional limitations may trigger or exacerbate psychological distress. This narrative review focuses on coronary artery disease, acute coronary syndrome, and heart failure, and summarizes the epidemiological associations, clinical implications, potential mechanisms, and management strategies related to anxiety and depression. The mechanisms discussed include neuroendocrine and autonomic dysregulation, inflammation, mitochondrial dysfunction, gut microbiota alterations, and heart-brain communication. The review also examines integrated approaches involving cardiovascular treatment, psychological interventions, exercise rehabilitation, pharmacotherapy, social support, and digital management. Future research should standardize diagnostic criteria and outcome measures, clarify key mechanistic pathways, develop clinically meaningful phenotypic classifications, identify useful biomarkers, and evaluate comprehensive interventions in multicenter studies. These efforts may strengthen early detection, risk stratification, individualized treatment, and long-term management for patients with coexisting cardiovascular and mental health conditions.