300 Section - Not all hearts heal the same: the prognostic role of baseline wellbeing in Cardiac Rehabilitation

Objectives : Psychological distress is common among patients undergoing Cardiac Rehabilitation programs (CRP) and may impact adherence and clinical outcomes. Despite its clinical relevance, psychological support is not routinely integrated into CRPs. This study investigates whether baseline emotional distress predicts differential responses on RCP putcomes.

Design: We conducted a retrospective observational study (Jan2023–Oct2025) involving patients enrolled in a multidisciplinary Cardiac Rehabilitation Program (CRP). The CRP included supervised aerobic and resistance training 2x/week for 3-months, plus structured education on diet and stress management. Psychological support was offered voluntarily, and patients were grouped by intervention status for baseline comparisons. Emotional distress was assessed using the Hospital Anxiety and Depression Scale (HADS); scores >7 in each subscale Outcomes like body composition, muscle strength, cardiopulmonary fitness (VO₂, METs), and patient-reported measures—were analyzed by emotional profile

Results: 223 patients were assessed. Baseline characteristics (Table 1) were comparable across groups, except for age and emotional distress, which were higher among those who received psychological support. Emotional comorbidity was significantly more frequent in this group (64.3%vs.21.1%), and CAQ scores were also elevated (p >0.05). Among the 159 patients who completed the CRP, outcomes were analyzed according to baseline emotional profile, regardless of psychological intervention status. Patients without emotional symptoms showed the most consistent improvements across physical, functional, and lifestyle domains. Those with anxiety or comorbidity also demonstrated gains in strength, fitness, and quality of life. In contrast, patients with depression showed limited benefit in all domains (Table 2).

Conclusion: Baseline emotional distress was associated with differential responses to CRP, with depression linked to poorer outcomes compared to other emotional profiles.Those who received psychological support had greater baseline emotional burden, but, the voluntary nature of the intervention and small sample size limit generalizability. These results underscore the need for personalized psychological interventions to better support emotionally vulnerable patients.