With heart and soul

Last updated on March 28, 2024 First published on September 05, 2023

If the psyche is doing well, this has a positive effect on the recovery process after heart surgery. A study is looking at exactly how the heart and soul influence each other to predict and prevent complications in heart patients with mental health problems.

“You have to imagine me as more or less a stranger shutting down your heart during surgery.” The statement by Omer Dzemali, Director of the Clinic for Cardiac Surgery at the USZ, immediately triggers unease – even in a person who does not have a heart condition. People undergoing cardiac surgery are greatly burdened by the often life-threatening risks. The loss of control during the eingriff can further exacerbate this. In fact, a significant proportion of these patients therefore struggle with psychological symptoms or even illnesses such as depression or anxiety disorders, both before and after surgery.

Holistic treatment

What has been standard practice in cardiology at the USZ for some time now is now also making its way into cardiac surgery – as one of the first in Switzerland. Omer Dzemali has been working closely with the USZ psychocardiology team at Zurich City Hospitals for several years. Together, they developed an approach to identify patients’ psychological distress at an early stage and treat it, if desired. He is now establishing this offer at the USZ as well. Patients demonstrably profit from this. “It has been adequately researched that quality of life increases significantly when psychological symptoms are treated in addition to physical symptoms. A stable mental constitution can have a positive effect on recovery,” explains Roland von Känel, Director of the Clinic for Consultant Psychiatry and Psychosomatics.

Minimize risks

It makes sense: Those who are relaxed and confident usually feel better physically, and vice versa. But to what extent do the body and mind actually affect each other during cardiac interventions, and what are potential indicators that predict this? This is exactly what the two clinic directors and their teams are now trying tofind out. “Our collaborative study indicates that individuals with depressive symptoms or anxiety disorders after heart surgery have significantly higher levels of inflammation, among other symptoms, than those operated on without psychological impairment,” explains Omer Dzemali. Somewhat elevated levels of inflammation are normal after major surgery, but the higher they are, the greater the risk of complications. “We are therefore also interested in whether certain psychological abnormalities prior to cardiac intervention are directly related to specific disturbances in recovery after the intervention,” adds Roland von Känel.

Temporary friend

The study is now continuing at both sites. Should Roland von Känel and Omer Dzemali find significant correlations, this would be groundbreaking. Thus, with targeted psychological interventions before the interriff tion, later impairments could be reduced or even prevented, if necessary. Omer Dzemali says: “I am convinced that if we treat people holistically, addressing all levels, supporting them with our professionalism as a ‘temporary friend’, we can also improve the quality of the results of an intervention on the heart. And this is exactly what we now want to prove with our research.”

The study by Roland von Känel and Omer Dzemali will run until 2024 and is funded by the Swiss National Science Foundation SNSF.

Omer Dzemali, Prof. Dr. med. Dr. h.c.

Director of Department, Department of Cardiac Surgery

Tel. +41 44 255 47 29
Specialties: Minimally invasive surgery , Mitral valve surgery , Reconstructive surgery

Roland von Känel, Prof. Dr. med.

Director of Department, Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine

Specialties: Stress, stress biology and stress-related diseases, Psychocardiology, Body symptom disorders (fatigue, pain)