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

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.