Depression and disease severity as correlates of everyday physical activity in heart transplant candidates

Abstract

Summary It is unclear to what extent patients awaiting heart transplantation (HTx) engage in physical activities. We examined the everyday physical activity and its associations with depressive symptoms and disease severity in 318 patients newly registered for HTx in the multi‐site study ‘Waiting for a New Heart’ (aged 53.5 ± 11.4 years, 18% female patients). Participants completed questionnaires assessing depressive symptomatology and physical activity (number of physical activities, caloric expenditure associated with each activity), and estimated the distance they were able to walk without a break. Medical parameters at the time of listing [e.g. peak oxygen consumption (peakVO2); the German Transplant Society Score (GTSS)] were provided by Eurotransplant. Almost 50% of patients engaged in activities of daily living (housework, walking), but <10% engaged in regular exercise. All physical activity measures correlated significantly with peakVO2 (Ps < 0.01). Elevated depression scores were present in 39% of patients. Controlling for confounding variables (e.g. peakVO2, diastolic blood pressure, GTSS, age), depressive symptomatology accounted for additional variance in all physical activity measures (Ps < 0.05). The association of depressive symptoms with reduced physical activity suggests two important perspectives: attempts to increase physical activity (especially in the area of daily living) might benefit from targeting depression, and increased physical activity might also help to reduce depressive symptoms.

Physical rehabilitation of patients after heart transplantation

“…Кроме того, регулярная физическая актив-ность (по крайней мере, 4 раза в неделю) более часто отме-чается для повседневных нагрузок, таких как домашняя работа (41,2 %), прогулки (26,1 %) или ходьба в магазин (12,3 %), чем для физических тренировок (6 % для стрет-чинга, 4 % для велоэргометра и 1 % для кардиотренинга и йоги). При этом 10,4 % пациентов не выполняли ника-ких повседневных нагрузок [19].…”

Medical and psychosocial predictors of mechanical circulatory support device implantation and competing outcomes in the Waiting for a New Heart Study

“…Comparisons of non-participants with participating patients have been reported previously. 6,7 Measures Eurotransplant provided medical information at time of listing (Table 1). This included anthropometric variables, medications, creatinine, cardiac index, pulmonary capillary wedge pressure (PCWP), and parameters to calculate the Heart Failure Survival Score (HFSS; Table 1), 8 which has acceptable prognostic performance in the era of ␤-blockers, 4,9 implantable cardioverter defibrillators (ICD), and resynchronization therapy.…”

“…The study procedures have been described previously. 3,6,7 Briefly, between April 2005 and December 2006, written informed consent was obtained from consecutive patients who were newly registered on the waiting list. Exclusion criteria were age Ͻ 18 years, listing for combined heart-lung Tx, re-Tx, not being fluent in German, and being too severely ill to participate, as determined by the local physician.…”

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper

“…It adversely affects adherence to exercise and participation in daily life activities [185]. Its incidence was 7.9% for severe or moderate depression [186] and 33-69% for the less severe levels [187,188].…”