Impact of depressive disorders on clinical outcomes in patients with chronic heart failure

Grzegorz Opielak; Tomasz Powrózek; Aneta Skwarek-Dziekanowska; Grzegorz Sobieszek; Katarzyna Kamińska; Alicja Wójcik-Załuska; Teresa Małecka-Massalska

doi:10.5114/aic.2022.115819

Impact of depressive disorders on clinical outcomes in patients with chronic heart failure

Postepy Kardiol Interwencyjnej. 2022 Mar;18(1):34-42. doi: 10.5114/aic.2022.115819. Epub 2022 Apr 27.

Authors

Grzegorz Opielak¹, Tomasz Powrózek¹, Aneta Skwarek-Dziekanowska², Grzegorz Sobieszek², Katarzyna Kamińska¹, Alicja Wójcik-Załuska³, Teresa Małecka-Massalska¹

Affiliations

¹ Department of Human Physiology, Medical University of Lublin, Lublin, Poland.
² Department of Cardiology, 1 Military Clinical Hospital with the Outpatient Clinic, Lublin, Poland.
³ Department of Physical Therapy and Rehabilitation, Medical University of Lublin, Lublin, Poland.

Abstract

Introduction: To date, there are no literature reports of research investigating the relationship between depression and chronic heart failure (CHF) in relation to selected nutritional, cardiac and laboratory parameters.

Aim: To compare CHF parameters in relation to nutritional and laboratory parameters between depressed and non-depressed patients.

Material and methods: We enrolled 94 CHF individuals from Lubelskie Voivodeship to assess depression prevalence and to compare values of cardiac, laboratory and nutritional parameters between depressed and non-depressed patients.

Results: Depression was diagnosed in 66 (70.2%) individuals. We noted significantly lower ejection fraction (EF) (EF%) in the group of depressive patients compared to disease-free individuals (mean EF%: 42 ±12 and 49 ±9; p = 0.030) and worse outcomes in NYHA examination (p < 0.001). Depressed patients had lower body weight (p = 0.023), body mass index (BMI) (p = 0.044), serum albumin concentration (p = 0.015), and hemoglobin concentration (p = 0.042) and an elevated level of C-reactive protein (CRP) (p = 0.025) in comparison to the non-depressed group. The moderate or severely depressed group had a lower level of EF% (p = 0.019) and higher left anterior descending artery (LAD) (p = 0.040) compared with the group suffering from mild depression. We observed greater susceptibility to develop cachexia in patients diagnosed as moderately or severely depressed (p = 0.030). Moreover, in the mentioned group of patients, lower values of body weight (p = 0.037), fat-free mass (FFM) (p = 0.022) and hemoglobin concentration (p = 0.007) were found. Moreover, an inverse correlation between Beck Depression Inventory (BDI) score and EF% (r = -0.371; p = 0.017) was recorded.

Conclusions: Depression in CHF patients is associated with worse cardiac, laboratory and nutritional outcomes. Unfavorable clinical characteristics of CHF patients are related to depression severity.

Keywords: cachexia; chronic heart failure; depression; inflammation; nutrition.