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Depression and heart failure
474
Letters to the Editor
References [1] Wu YP, Stella PR, Chen SF, et al. Beta-radiation reduces the reactivity of extra cellular matrix proteins in intravascular brachytherapy (IVBT), resulting in decreased platelet adhesion. Int J Cardiol 2012;156:283–8. [2] Xu JY, Jin B, Zhao Y, Wang K, Xia XH. In situ monitoring of the DNA hybridization by attenuated total reflection surface-enhanced infrared absorption spectroscopy. Chem Commun (Camb) 2012;48:3052–4. [3] Raizner AE, Kaluza GL, Ali NM. Clinical experience with a spiral balloon centering catheter for the delivery of intracoronary radiation therapy. Cardiovasc Radiat Med 1999;1:214–9.
[4] Goodfellow M, Hayes A, Murphy S, et al. A retrospective study of (90)Strontium plesiotherapy for feline squamous cell carcinoma of the nasal planum. J Feline Med Surg 2006;8:169–76. [5] Hammond GM, Gordon IK, Theon AP, et al. Evaluation of strontium Sr 90 for the treatment of superficial squamous cell carcinoma of the nasal planum in cats: 49 cases (1990–2006). J Am Vet Med Assoc 2007;231:736–41. [6] Belbachir Karima, Noreen Razia, Gouspillou Gilles, Petibois Cyril. Collagen types analysis and differentiation by FTIR spectroscopy. Anal Bioanal Chem 2009;395:829–37.
0167-5273/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2012.05.058
Depression and heart failure Meltem Refiker Ege a,⁎, Nuryil Yilmaz b, Mehmet Birhan Yilmaz c a b c
Koru Hospital, Clinic of Cardiology, Ankara, Turkey Sivas Cumhuriyet University, Medical Faculty, Department of Psychiatry, Sivas, Turkey Sivas Cumhuriyet University, Medical Faculty, Department of Cardiology, Sivas, Turkey
a r t i c l e
i n f o
Article history: Received 11 May 2012 Accepted 12 May 2012 Available online 2 June 2012 Keywords: Heart failure Depression Mortality
Dear editor; We read with great interest the recently published article of Lossnitzer et al. [1] related with the incidence rates and predictors of major and minor depression in patients with heart failure. In this recent report, the authors found high rate of depression in patients with heart failure. Multiple factors such as previous depressive episode, history of previous resuscitation, current smoking, frequent visits to general practitioner, New York Heart Association functional class, patient health quastionnaire score and SF-36 physical functioning were found to be the independent predictors for the development of minor and major depression. Although the presence of one or more of these factors can precipitate the depressive symptoms, the presence of underlying undiagnosed depression can also cause increased subjective symptom reporting and worsening functional status. Most of the patients with congestive heart failure prefer sedentary life which may trigger depressive symptoms. In time, depressed patients can be more sensitive to symptoms and can express more severe fatigue, dyspnea and functional impairment than patients with no any psychological problem. Some patients with heart failure with lower ejection fraction can remain asymptomatic while others with higher
⁎ Corresponding author at: Koru Hospital, Clinic of Cardiology, Oguzlar mah, 1377 sok., no 21, Balgat, Ankara, Turkey. Tel.: +90 312 287 97 97; fax: +90 312 287 98 98. 0167-5273/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2012.05.067
ejection fraction can be physically limited because of exaggerated fatigue and dyspnea related with the accompanying depression. On the other hand although factors associated with depression in patients with heart failure are controversial, depressive symptoms in this group of patients are found to be associated with adverse outcomes [2]. In a recent study of Veien et al. [3] the authors have established that pharmacologically treated depression is associated with an increased mortality risk. Depression can affect patient adherence to recommended interventions. This can trigger symptoms such as dyspnea, fatigue and edema which are the main clinical symptoms thought to limit function in people with heart failure [4]. Although, management of these symptoms can be ameliorated with aggressive medical therapy depression can limit person's capacity to learn medical regimens and also can lead to reduced motivation during rehabilitation. Therefore depression can result in disability and thereby increased mortality. In conclusion, as well as the presence of heart failure is accepted as a risk factor for the development of depression, depression alone can worsen the symptoms of heart failure. Although as it was established in this study, there are multiple factors related with the development of depression in patients with heart failure, management of heart failure, should be expanded from physical functioning to psychological functioning. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [5]. References [1] Lossnitzer N, Herzog W, Störk S, et al. Incidence rates and predictors of major and minor depression in patients with heart failure. Int J Cardiol Feb 16 2012, doi:10.1016/ j.ijcard.2012.01.062. [2] Jiang W, Alexander J, Christopher E, et al. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med 2001;161:1849–56. [3] Veien KT, Videbæk L, Schou M, Gustafsson F, Hald-Steffensen F, Hildebrandt PR. High mortality among heart failure patients treated with antidepressants. Int J Cardiol 2011;146:64–7. [4] Spertus JA, Tooley J, Jones P, et al. Expanding the outcomes in clinical trials of heart failure: the quality of life and economic components of EPHESUS (EPlerenone's neuroHormonal Efficacy and SUrvival Study). Am Heart J 2002;143:636–42. [5] Coats AJS, Shewan LG. Statement on authorship and publishing ethics in the International Journal of Cardiology. Int J Cardiol 2011;153:239–40.
Letters to the Editor
References [1] Wu YP, Stella PR, Chen SF, et al. Beta-radiation reduces the reactivity of extra cellular matrix proteins in intravascular brachytherapy (IVBT), resulting in decreased platelet adhesion. Int J Cardiol 2012;156:283–8. [2] Xu JY, Jin B, Zhao Y, Wang K, Xia XH. In situ monitoring of the DNA hybridization by attenuated total reflection surface-enhanced infrared absorption spectroscopy. Chem Commun (Camb) 2012;48:3052–4. [3] Raizner AE, Kaluza GL, Ali NM. Clinical experience with a spiral balloon centering catheter for the delivery of intracoronary radiation therapy. Cardiovasc Radiat Med 1999;1:214–9.
[4] Goodfellow M, Hayes A, Murphy S, et al. A retrospective study of (90)Strontium plesiotherapy for feline squamous cell carcinoma of the nasal planum. J Feline Med Surg 2006;8:169–76. [5] Hammond GM, Gordon IK, Theon AP, et al. Evaluation of strontium Sr 90 for the treatment of superficial squamous cell carcinoma of the nasal planum in cats: 49 cases (1990–2006). J Am Vet Med Assoc 2007;231:736–41. [6] Belbachir Karima, Noreen Razia, Gouspillou Gilles, Petibois Cyril. Collagen types analysis and differentiation by FTIR spectroscopy. Anal Bioanal Chem 2009;395:829–37.
0167-5273/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2012.05.058
Depression and heart failure Meltem Refiker Ege a,⁎, Nuryil Yilmaz b, Mehmet Birhan Yilmaz c a b c
Koru Hospital, Clinic of Cardiology, Ankara, Turkey Sivas Cumhuriyet University, Medical Faculty, Department of Psychiatry, Sivas, Turkey Sivas Cumhuriyet University, Medical Faculty, Department of Cardiology, Sivas, Turkey
a r t i c l e
i n f o
Article history: Received 11 May 2012 Accepted 12 May 2012 Available online 2 June 2012 Keywords: Heart failure Depression Mortality
Dear editor; We read with great interest the recently published article of Lossnitzer et al. [1] related with the incidence rates and predictors of major and minor depression in patients with heart failure. In this recent report, the authors found high rate of depression in patients with heart failure. Multiple factors such as previous depressive episode, history of previous resuscitation, current smoking, frequent visits to general practitioner, New York Heart Association functional class, patient health quastionnaire score and SF-36 physical functioning were found to be the independent predictors for the development of minor and major depression. Although the presence of one or more of these factors can precipitate the depressive symptoms, the presence of underlying undiagnosed depression can also cause increased subjective symptom reporting and worsening functional status. Most of the patients with congestive heart failure prefer sedentary life which may trigger depressive symptoms. In time, depressed patients can be more sensitive to symptoms and can express more severe fatigue, dyspnea and functional impairment than patients with no any psychological problem. Some patients with heart failure with lower ejection fraction can remain asymptomatic while others with higher
⁎ Corresponding author at: Koru Hospital, Clinic of Cardiology, Oguzlar mah, 1377 sok., no 21, Balgat, Ankara, Turkey. Tel.: +90 312 287 97 97; fax: +90 312 287 98 98. 0167-5273/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2012.05.067
ejection fraction can be physically limited because of exaggerated fatigue and dyspnea related with the accompanying depression. On the other hand although factors associated with depression in patients with heart failure are controversial, depressive symptoms in this group of patients are found to be associated with adverse outcomes [2]. In a recent study of Veien et al. [3] the authors have established that pharmacologically treated depression is associated with an increased mortality risk. Depression can affect patient adherence to recommended interventions. This can trigger symptoms such as dyspnea, fatigue and edema which are the main clinical symptoms thought to limit function in people with heart failure [4]. Although, management of these symptoms can be ameliorated with aggressive medical therapy depression can limit person's capacity to learn medical regimens and also can lead to reduced motivation during rehabilitation. Therefore depression can result in disability and thereby increased mortality. In conclusion, as well as the presence of heart failure is accepted as a risk factor for the development of depression, depression alone can worsen the symptoms of heart failure. Although as it was established in this study, there are multiple factors related with the development of depression in patients with heart failure, management of heart failure, should be expanded from physical functioning to psychological functioning. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [5]. References [1] Lossnitzer N, Herzog W, Störk S, et al. Incidence rates and predictors of major and minor depression in patients with heart failure. Int J Cardiol Feb 16 2012, doi:10.1016/ j.ijcard.2012.01.062. [2] Jiang W, Alexander J, Christopher E, et al. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med 2001;161:1849–56. [3] Veien KT, Videbæk L, Schou M, Gustafsson F, Hald-Steffensen F, Hildebrandt PR. High mortality among heart failure patients treated with antidepressants. Int J Cardiol 2011;146:64–7. [4] Spertus JA, Tooley J, Jones P, et al. Expanding the outcomes in clinical trials of heart failure: the quality of life and economic components of EPHESUS (EPlerenone's neuroHormonal Efficacy and SUrvival Study). Am Heart J 2002;143:636–42. [5] Coats AJS, Shewan LG. Statement on authorship and publishing ethics in the International Journal of Cardiology. Int J Cardiol 2011;153:239–40.