Ricerc@Sapienza

The main aim of the present project is to extend knowledge on the features of psychological functioning and indices of autonomic nervous system activity (e.g., HRV) that might influence the clinical conditions of ACS patients (particularly those presenting with AMI and TS). Moreover, the research will consider the impact of the doctor¿patient relationship and individualized psychological interventions on ACS outcomes.
In detail, the research project will aim at profiling ACS subtypes according to psychopathology, personality, and autonomic characteristics, in order to implement clinical interventions in the framework of personalized medicine. In the perspective of secondary prevention, it has become increasingly clear that the identification of psychological factors that might increase the risk of negative outcomes is crucial to implementing tailored clinical interventions, as well as promoting more effective and timely practices in various healthcare contexts. In the present research, particular attention will be given to a comparison of AMI and TS, because, despite the significant body of research on this subject, no definitive conclusion has been drawn about the role of clinical psychological factors in these syndromes (other than the role of depression in AMI). All psychological assessments will be realized using the soundest theoretical framework and most sophisticated tools available.
The project will also consider interventions to train cardiologists in relational and communication skills through a patient-centered perspective, in order to improve patient engagement and clinical outcomes. We believe that the complexity of the mind¿heart¿body connection compels multidisciplinary work in healthcare, to overcome the limitations of the disease-centered approach.
Personalized medicine is changing the clinical approach to patients, directing greater attention toward clinical decisions that are tailored to the characteristics of individual patients. Patient engagement, shared decision-making, narrative medicine and the facilitation of health literacy are key to achieving patient-centeredness. These patient-centered methods of care can be taught in the context of structured training programs (Volpe, Testa 2019). The integration of the narrative and digital approach can effectively address the challenge of an increasingly personalized and participated medicine (Mecarelli, Cenci 2020). Digital and asynchronous interaction enables sharing more personal and emotional experiences of the illness, with an improved management of time than in face-to-face interaction.
In synthesis, by tracking the trajectories connecting psychological risk factors to autonomic dysfunction and heart disease, we hope to contribute new insights to implement effective interventions of secondary prevention. Monitoring the trend of autonomic function over time may also help to measure the efficacy of psychological interventions in ACS patients. Finally, the close monitoring of patients¿ psychological characteristics, the training of cardiologists in doctor¿patient communication skills and the focus on the patients¿ engagement may provide additional insight into the factors involved in predicting patients¿ clinical outcomes and adherence to prescribed medication plans.
We are aware of the great ambition of this project, but it longs to mirror the revolution we expect to see in the medical field in the coming years. In particular, the project aims at overcoming the artificial boundaries drawn between mind and body and brain and heart, from diagnosis through to clinical intervention. We hope that the findings will support new practices that place the whole patient at the center of all medical interventions through authentic multidisciplinary work, where the interplay of psychological and somatic patterns is the clinical focus from the bedside through to recovery.