학술논문
Cross-lagged analyses of the bidirectional relationship between depression and markers of chronic heart failure.
Document Type
Academic Journal
Author
Lossnitzer N; Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Heidelberg, Germany.; Feisst M; Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.; Wild B; Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Heidelberg, Germany.; Katus HA; Department of Cardiology, Angiology and Pulmonology, University of Heidelberg, Heidelberg, Germany.; Schultz JH; Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Heidelberg, Germany.; Frankenstein L; Department of Cardiology, Angiology and Pulmonology, University of Heidelberg, Heidelberg, Germany.; Stock C; Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
Source
Publisher: Wiley Country of Publication: United States NLM ID: 9708816 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1520-6394 (Electronic) Linking ISSN: 10914269 NLM ISO Abbreviation: Depress Anxiety Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Depression is common in patients with chronic heart failure (CHF) and is a predictor of rehospitalization and mortality. However, the complex bidirectional relationships between these two conditions are barely understood. We investigated the course of depression and markers of CHF (New York Heart Association [NYHA] functional class, N-terminal-prohormone B-type natriuretic peptide [NT-proBNP], and left ventricular ejection fraction [LVEF]) in a longitudinal study over a period of 2 years, using three assessment points.
Methods: Data of n = 446 patients with documented CHF were analyzed using structural equation modeling. Specifically, a Bayesian cross-lagged structural equation model was applied.
Results: Our study revealed that an aggravation of depression predicted an increase in NYHA functional class (significant cross-lagged effect γh = 0.103, 95% confidence interval [CI] [0.017; 0.194]), whereas an increase in NYHA functional class did not predict an aggravation of depression (γ d = 0.002 95% CI [-0.057; 0.194]). This association was found only for NYHA functional class and depression-not for NT-proBNP and LVEF.
Conclusions: Experiencing depression and associated symptoms, such as lack of energy and fatigue, may lead to a further decrease of functional capacity, and consequently to a higher NYHA functional class in CHF patients. As NYHA functional class is associated with higher mortality, this may be a critical development for affected patients. Further studies are required to investigate whether or not this association could be an essential key that explains the pathway from depression to increased mortality in heart failure patients.
(© 2020 Wiley Periodicals LLC.)
Methods: Data of n = 446 patients with documented CHF were analyzed using structural equation modeling. Specifically, a Bayesian cross-lagged structural equation model was applied.
Results: Our study revealed that an aggravation of depression predicted an increase in NYHA functional class (significant cross-lagged effect γ
Conclusions: Experiencing depression and associated symptoms, such as lack of energy and fatigue, may lead to a further decrease of functional capacity, and consequently to a higher NYHA functional class in CHF patients. As NYHA functional class is associated with higher mortality, this may be a critical development for affected patients. Further studies are required to investigate whether or not this association could be an essential key that explains the pathway from depression to increased mortality in heart failure patients.
(© 2020 Wiley Periodicals LLC.)