Psychologische und klinische Effekte einer Gesprächsintervention bei Herzklappenoperationen im Rahmen der ValvEx-Studie
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Abstract
Valvular heart diseases are one of the most common cardiac conditions and often require surgical intervention. In addition to medical factors, psychological aspects such as anxiety and depression are gaining increasing importance in the recovery process and quality of life following cardiac surgery. Previous studies, such as the PSY-HEART I study, have shown that preoperative psychological interventions have positive effects on patient expectations and postoperative outcomes in bypass patients. However, similar investigations in patients undergoing valve surgery have been lacking. The aim of the ValvEx-trial was therefore to examine the impact of an expectation-oriented preoperative psychological intervention on the postoperative recovery process and psychological adjustment in patients undergoing elective heart valve surgery.
In this prospective, randomized controlled trial, 89 patients scheduled for elective heart valve surgery were allocated to either an intervention group (EXPECT), which received an expectation-focused psychological counseling session the day before surgery, or a control group (SOC) receiving standard medical care. Additional assessments were conducted the day before surgery, as well as four to six days and three months postoperatively using standardized questionnaires.
No significant differences were found between the intervention and control groups regarding postoperative quality of life or disease-related impairment at either the postoperative or follow-up assessment. However, subgroup analyses indicated that patients with a high need for information showed significantly reduced anxiety levels after the EXPECT intervention. Furthermore, depression proved to be a key predictor of postoperative outcomes: Higher preoperative depression levels were significantly associated with greater disease-related impairment and lower quality of life throughout the recovery period.
The ValvEx-trial did not provide general evidence for the effectiveness of the psychological intervention in heart valve patients. Nevertheless, relevant influencing factors were identified that highlight the need for differentiated and individualized psychological support before cardiac surgery. Preoperative depression in particular proved to be a strong predictor of psychological outcomes. Findings suggest that the EXPECT intervention may be associated with less favorable outcomes in patients with elevated depressive symptoms. In contrast, patients with a high need for information seemed to benefit from the intervention. Future psychological approaches should be more adapted to individual patient needs and potentially carried out more intensively or in several phases to improve their effectiveness in clinical practice. Further studies are required for this.
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Issued: 2026-01-08
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Has part: (DOI) 10.3389/fcvm.2023.1105507.Has part: (DOI) 10.1016/j.ahj.2025.01.006.Has part: (DOI) 10.1038/s41598-025-93467-7.
Faculty
FB20:Medizin
Language
de
Keywords
HerzklappenoperationHerzklappenerkrankungenHerzchirurgiePsychokardiologieGesprächsinterventionErwartungenDepressivitätLebensqualitätValvEx
DFG-subjects
2.22-26 - Herz- und Gefäßchirurgie
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Lenz, Juliane: Psychologische und klinische Effekte einer Gesprächsintervention bei Herzklappenoperationen im Rahmen der ValvEx-Studie. : 2026-01-08.
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Except where otherwised noted, this item's license is described as Attribution-NoDerivs 3.0 Germany