Scientific Online Resource System

Scripta Scientifica Medica

Depression in patients with heart failure

Mariya Georgieva, Lilyana Mircheva, Yoto Yotov

Abstract

Introduction: Heart failure (HF) is a chronic progressive syndrome, which is a result of preceding heart diseases and manifests with serious symptoms. Depression and anxiety are frequent comorbidities in chronic HF, which deteriorate the general status of the patients and are related to unfavorable health results—increased number of hospitalizations, deteriorated quality of life, and elevated mortality.

Aim: The aim of this article is to assess the tendency to fall into depression of patients with HF in NYHA class III-IV, hospitalized in the non-invasive cardiology clinic of St. Marina University Hospital, Varna and the link to socioeconomic factors—social isolation, family status, educational level, region of residence and so on.

Materials and Methods: Overall, 39 patients with HF (17 women and 22 men) were investigated. They were in III-IV NYHA functional class during hospitalization. After preliminarily informed consent, they were asked to fill out a validated screening questionnaire for depression in adults—the 15-item Geriatric Depression Scale (GDS). The link to the patients’ socioeconomic, demographic, biological, and clinical characteristics was sought with the help of a multi-factor linear and logistic regression analysis.

Results: The results for the level of depression among HF patients were related to socioeconomic factors—region of residence, level of education, social isolation as well as to other variables—gender, age, and systolic left ventricular function assessed through the ejection fraction (EF). Higher levels of depression were observed in patients who resided in larger populated areas, with higher level of education and patients living alone. As far as gender was concerned, females were more susceptible to depressive episodes than males. At an average EF of 49.54 ±15.29%, the decreased left ventricular systolic function was also a factor of the degree of development of anxiety and depression. In a multi-factor analysis, however, only living alone was related to enhanced depressive attitude.

Conclusion: Depression/anxiety in HF patients requires increased need of health care, shows poor health results, has high costs for treatment related to the serious symptoms, disability and high mortality. Regardless of that, no programs for timely detection, diagnosis, and treatment have been developed yet.


Keywords

depression, heart failure, lifestyle, socioeconomic factors

Full Text


References

Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28–e292. doi: 10.1161/01.cir.0000441139.02102.80.

Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart. 2007; 93(9):1137–46. doi: 10.1136/hrt.2003.025270.

Redfield MM, Jacobsen SJ, Burnett JC, Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA. 2003; 289(2):194–202. doi: 10.1001/jama.289.2.194.

McMurray JJ, Stewart S. The burden of heart failure. Eur Heart J. 2002; 4(suppl D):D50-8.

Mamas MA, Sperrin M, Watson MC, Coutts A, Wilde K, Burton C, et al. Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland. Eur J Heart Fail. 2017; 19(9):1095-104. doi: 10.1002/ejhf.822.

Coelho R, Ramos S, Prata J, Bettencourt P, Ferreira A, Cerqueira-Gomes M. Heart failure and health related quality of life. Clin Pract Epidemiol Ment Health. 2005;1:19. doi: 10.1186/1745-0179-1-19.

Celano CM, Villegas AC, Albanese AM, Gaggin HK, Huffman JC. Depression and anxiety in heart failure: a review. Harv Rev Psychiatry. 2018;26(4):175-84. doi: 10.1097/HRP.0000000000000162.

Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure: a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006; 48(8):1527–37. doi: 10.1016/j.jacc.2006.06.055.

Daskalopoulou M, George J, Walters K, Osborn DP, Batty GD, Stogiannis D, et al. Depression as a risk factor for the initial presentation of twelve cardiac, cerebrovascular, and peripheral arterial diseases: Data Linkage Study of 1.9 million women and men. PLoS One. 2016;11(4):e0153838. doi: 10.1371/journal.pone.0153838.

Sullivan M, Levy WC, Russo JE, Spertus JA. Depression and health status in patients with advanced heart failure: a prospective study in tertiary care. J Card Fail. 2004; 10(5):390-6. doi: 10.1016/j.cardfail.2004.01.011.

Moraska AR, Chamberlain AM, Shah ND, Vickers KS, Rummans TA, Dunlay SM, et al. Depression, healthcare utilization and death in heart failure: a community study. Circ Heart Fail. 2013;6(3):387–94. doi: 10.1161/CIRCHEARTFAILURE.112.000118.

Adelborg K, Schimidt M, Sundbøll J, Pedersen L, Videbech P, Bøtker HE, et al. Mortality risk among heart failure patients with depression: A nationwide population-based cohort study. J Am Heart Assoc. 2016;5(9):e004137. doi: 10.1161/JAHA.116.004137.

Fan H, Yu W, Zhang Q, Cao H, Li J, Wang J, et al. Depression after heart failure and risk of cardiovascular and all-cause mortality: a meta-analysis. Prev Med. 2014;63:36–42. doi: 10.1016/j.ypmed.2014.03.007.

Frasure-Smith N, Lespérance F, Habra M,Talajic M, Khairy P, Dorian P, et al. Elevated depression symptoms predict long-term cardiovascular mortality in patients with atrial fibrillation and heart failure. Circulation. 2009;120(2):134-40. doi: 10.1161/CIRCULATIONAHA.109.851675.

Pintor L. Heart failure and depression, an often neglected combination. Rev Esp Cardiol. 2006; 59(8):761-5.

Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey MB, et al. Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res. 1983; 17(1):37-49. doi: 10.1016/0022-3956(82)90033-4.

Mbakwem A, Aina F, Amadi C. Depression in patients with heart failure: is enough being done? Card Fail Rev. 2016;2(2):110–2. doi:10.15420/cfr.2016:21:1.

Gottlieb SS, Khatta M, Friedmann E, Einbinder L, Katzen S, Baker B, et al. The influence of age, gender and race on the prevalence of depression in heart failure patients. J Am Coll Cardiol. 2004; 43(9):1542-9. doi: 10.1016/j.jacc.2003.10.064.

Polikandrioti M, Christou A, Morou Z, Kotronoulas G, Evagelou H, Kyritsi H. Εvaluation of depression in patients with congestive failure. Ηealth Sci J. 2010; 4(1):37-47.

Thomas SA, Friedmann E, Khatta M, Cook LK, Lann AL. Depression in patients with heart failure: physiologic effects, incidence, and relation to mortality. AACN Clin Issues. 2003;14(1):3-12. doi: 10.1097/00044067-200302000-00002.

Manemann SM, Chamberlain AM, Roger VL, Griffin JM, Boyd CM, Cudjoe TKM, et al. Perceived social isolation and outcomes in patients with heart failure. J Am Heart Assoc. 2018; 7(11):e008069. doi: 10.1161/JAHA.117.008069.

Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. 2016; 102(13):1009–16. doi: 10.1136/heartjnl-2015-308790.

Xia N, Li H. Loneliness, social isolation, and cardiovascular health. Antioxid Redox Signal. 2018; 28(9):837-51. doi: 10.1089/ars.2017.7312.

Zahid I, Baig MA, Gilani JA, Waseem N, Ather S, Farooq AS, et al. Frequency and predictors of depression in congestive heart failure. Indian Heart J. 2018; 70(Suppl.3):S199-S203. doi: 10.1016/j.ihj.2018.10.410.

Lefteriotis C. Depression in heart failure patients. Health Sci J. 2013; 7(4):349-55.

Faller H, Steinbuchel T, Stoerk S, Scholwater M, Ertl G, Angermann C. Impact of depression on quality of life assessment in heart failure. Int J Cardiol. 2010; 142(2):133-7. doi: 10.1016/j.ijcard.2008.12.093.

Vaccarino V, Kasl SV, Abramson J, Krumholz HM. Depressive symptoms and risk of functional decline and death in patients with heart failure. J Am Coll Cardiol. 2001;38(1):199–205. doi: 10.1016/s0735-1097(01)01334-1.

van Melle JP, de Jonge P, Ormel J, Crijns HJ, van Veldhuisen DJ, Honig A, et al. MIND-IT Investigators. Relationship between left ventricular dysfunction and depression following myocardial infarction: data from the MIND-IT. Eur Heart J. 2005;26(24):2650–6. doi: 10.1093/eurheartj/ehi480.




DOI: http://dx.doi.org/10.14748/ssm.v0i0.7173
Array
Article Tools
Email this article (Login required)
About The Authors

Mariya Georgieva
Medical University of Varna
Bulgaria

Department of Nursing Care, Faculty of Public Health

Lilyana Mircheva
Medical University of Varna
Bulgaria

First Department of Internal Diseases, Faculty of Medicine

Yoto Yotov
Medical University of Varna
Bulgaria

First Department of Internal Diseases, Faculty of Medicine

Font Size


|