Frailty is prevalent among patients with advanced symptomatic heart failure referred for heart transplantation and is associated with increased mortality.

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This study evaluated associations between chronic breathlessness and: anxiety; depression; functional status in the general population. MethodsThis cross sectional cohort of consenting adults (≥18 years) used an online survey. Quota sampling (n=3,000) was employed reflecting the 2016 national census for sex, age and place of residence. Other data included: Patient Health Questionnaire for Depression and Anxiety (PHQ-4); the modified Medical Research Council (mMRC) breathlessness scale and the Australia-modified Karnofsky Performance Scale (AKPS). Multinomial logistic regression assessed predictors. Results2977 respondents had all relevant scores; female-51.2%; median age 45.0 (range 18-92). Prevalence of breathlessness (mMRC ≥ 2) was 2.4%; anxiety 6.0%; depression 2.7%; coexisting anxiety/depression 6.1% and poorer functional status (AKPS ≤60) 1.6%.Poorest function was in the co-existing anxiety/depression group with 11.6%. The highest proportions of people with breathlessness were found in the co-existing anxiety/depression group (10.6%) and depression only (8.8%).In multinomial regression, depression only and co-existing anxiety/depression were predicted by older age, longer duration of breathlessness, and poorer functional status (AKPS ≤60). The relationship between poorer functional status and co-existing anxiety/depression was striking (OR 16.1; 95% 8.3, 31.4).Adjusted odds ratios for breathlessness and: depression only was 5.5 (95% CI 2.3,12.9); and 5.1 for co-existing anxiety/depression group (95% CI 2.7,9.7). ConclusionClinically important breathlessness (mMRC ≥2) was associated with depression only and coexisting anxiety/depression. Poorer function associated with psychological morbidity in the general population requires further research.

This herbal formula containing Chinese herbs and Cimicifuga cannot be recommended to alleviate menopausal vasomotor symptoms or improve quality of life.