No abstract

Renal denervation has been shown to reduce blood pressure in patients with uncontrolled hypertension, but less is known about its impact on quality of life. This analysis evaluated 12‐month blood pressure and quality of life outcomes in 934 patients from the Global SYMPLICITY Registry who completed the EuroQoL five‐dimensions three‐level questionnaire (EQ‐5D‐3L). At baseline, 32% of patients reported anxiety/depression and 48% reported pain/discomfort. At 12 months (n=496), office and 24‐hour ambulatory systolic blood pressure were reduced by 13.9±26.6 and 7.7±19.3 mm Hg, respectively, and 8% (P<.001) more patients reported no problems in anxiety/depression. Furthermore, numerically more patients reported no problems in pain/discomfort (4%, P=.08). Perceived health‐related quality of life (visual analog scale) improved from baseline to 12 months (68±18 vs 73±17, P<.001), and the improvement was largest among patients with severe anxiety/depression at baseline (50±24 vs 64±22, P=.005 [n=32]). In this analysis, renal denervation was associated with a significant improvement in health‐related quality of life, particularly anxiety/depression.

AimsThe Anxiety-CHF (Anxiety in patients with Chronic Heart Failure) study investigated heart-focused anxiety (HFA, with the dimensions fear, attention, and avoidance of physical activity), general anxiety, depression, and quality of life (QoL) in patients with heart failure. Psychological measures were assessed before and up to 2 years after the implantation of an implantable cardioverter defibrillator (ICD) with or without cardiac resynchronization therapy defibrillator (CRT-D). Methods and results One hundred thirty-two patients were enrolled in this monocentric prospective study (44/88 CRT-D/ ICD, mean age 61 ± 14 years, mean left ventricular ejection fraction 31 ± 9%, and 29% women). Psychological assessment was performed before device implantation as well as after 5, 12, and 24 months. After device implantation, mean total HFA, HFA-fear, HFA-attention, general anxiety, and QoL improved significantly. Depression and HFA-related avoidance of physical activity did not change. CRT-D patients compared with ICD recipients and women compared with men reported worse QoL at baseline. Younger patients (

Zusammenfassung Die Herzinsuffizienz kann psychosoziale Faktoren wie Lebensqualit?t, Depression und Angst sowie die kognitive Leistungsf?higkeit der Patienten negativ beeinflussen. Aufgrund der hohen Pr?valenz und der ung?nstigen prognostischen Bedeutung psychosozialer Faktoren sind diese in der Behandlung herzinsuffizienter Patienten zu ber?cksichtigen. Psychische Belastungsfaktoren wie z.?B. depressive St?rungen und kognitive Defizite k?nnen negative Effekte auf das Krankheitsverhalten in Form von verminderter Bewegung und Adh?renz aus?ben. Daher ist bei Patienten mit chronischer Herzinsuffizienz ein Screening auf Depression, Angstst?rungen und Einschr?nkung der kognitiven F?higkeiten empfehlenswert. Therapeutisch erweisen sich vor allem psychotherapeutische Interventionen zur Besserung der Angst und Depression als wirksam. Die Bedeutung einer medikament?sen antidepressiven Therapie mit SSRI bei Herzinsuffizienz ist aufgrund neutraler Studienergebnisse nicht abschlie?end gekl?rt.