Global Prevalence of Depression among Heart Failure Patients: A Systematic Review and Meta-Analysis

Moradi, Mohammad; Doostkami, Mahboobeh; Behnamfar, Niaz; Rafiemanesh, Hosein; Behzadmehr, Razieh

doi:10.1016/j.cpcardiol.2021.100848

Cited by 45 publications

(42 citation statements)

References 22 publications

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“…Others have reported that HF patients with depression have lower treatment adherence, one element of self-care maintenance. Self-care neglect may contribute to the reduced quality of life and increased mortality seen in persons with HF who are depressed 39 …”

Section: Problem Person and Environmental Factorsmentioning

confidence: 99%

“…Self-care neglect may contribute to the reduced quality of life and increased mortality seen in persons with HF who are depressed. 39 Comorbid conditions make HF self-care difficult because symptoms may overlap, causing conflict regarding which set of self-care skills to use. 30 Previous studies have shown that patients with more comorbidities have poorer HF self-care 40 and self-care is better when patients are free from comorbid conditions.…”

Section: Problem Person and Environmental Factorsmentioning

confidence: 99%

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The Situation-Specific Theory of Heart Failure Self-care

2022

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Many studies of heart failure (HF) self-care have been conducted since the last update of the situation-specific theory of HF self-care. Objective The aim of this study was to describe the manner in which characteristics of the problem, person, and environment interact to influence decisions about self-care made by adults with chronic HF. Methods This study is a theoretical update. Literature on the influence of the problem, person, and environment on HF self-care is summarized. Results Consistent with naturalistic decision making, the interaction of the problem, person, and environment creates a situation in which a self-care decision is needed. Problem factors influencing decisions about HF self-care include specific conditions such as cognitive impairment, diabetes mellitus, sleep disorders, depression, and symptoms. Comorbid conditions make HF self-care difficult for a variety of reasons. Person factors influencing HF self-care include age, knowledge, skill, health literacy, attitudes, perceived control, values, social norms, cultural beliefs, habits, motivation, activation, self-efficacy, and coping. Environmental factors include weather, crime, violence, access to the Internet, the built environment, social support, and public policy. Conclusions A robust body of knowledge has accumulated on the person-related factors influencing HF self-care. More research on the contribution of problem-related factors to HF self-care is needed because very few people have only HF and no other chronic conditions. The research on environment-related factors is particularly sparse. Seven new propositions are included in this update. We strongly encourage investigators to consider the interactions of problem, person, and environmental factors affecting self-care decisions in future studies.

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Section: Problem Person and Environmental Factorsmentioning

confidence: 99%

Section: Problem Person and Environmental Factorsmentioning

confidence: 99%

The Situation-Specific Theory of Heart Failure Self-care

2022

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“…That a primary heart dysfunction negatively impacts on the correct function of higher neuronal centers is now supported by a large number of researches. As an example, it is a well-accepted notion that patients suffering from HF have increased incidence of stroke (mainly attributed to reduction in brain perfusion caused by cardiac contractile dysfunction), but also show cognitive decline, anxiety (Scherbakov and Doehner, 2018 ) and depression (Moradi et al, 2021 ). These may in turn, reflect on the activity of cardiac autonomic efferents, in a vicious cycle whereby cardiac pathology alters “heart-to-brain” communication, affecting “brain-to-heart” response, further compromising heart structure and function.…”

Section: May Optogenetics Shed Light On the Unexpected “Heart-to-brain” Correspondence?mentioning

confidence: 99%

Neurohumoral Cardiac Regulation: Optogenetics Gets Into the Groove

et al. 2021

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The cardiac autonomic nervous system (ANS) is the main modulator of heart function, adapting contraction force, and rate to the continuous variations of intrinsic and extrinsic environmental conditions. While the parasympathetic branch dominates during rest-and-digest sympathetic neuron (SN) activation ensures the rapid, efficient, and repeatable increase of heart performance, e.g., during the “fight-or-flight response.” Although the key role of the nervous system in cardiac homeostasis was evident to the eyes of physiologists and cardiologists, the degree of cardiac innervation, and the complexity of its circuits has remained underestimated for too long. In addition, the mechanisms allowing elevated efficiency and precision of neurogenic control of heart function have somehow lingered in the dark. This can be ascribed to the absence of methods adequate to study complex cardiac electric circuits in the unceasingly moving heart. An increasing number of studies adds to the scenario the evidence of an intracardiac neuron system, which, together with the autonomic components, define a little brain inside the heart, in fervent dialogue with the central nervous system (CNS). The advent of optogenetics, allowing control the activity of excitable cells with cell specificity, spatial selectivity, and temporal resolution, has allowed to shed light on basic neuro-cardiology. This review describes how optogenetics, which has extensively been used to interrogate the circuits of the CNS, has been applied to untangle the knots of heart innervation, unveiling the cellular mechanisms of neurogenic control of heart function, in physiology and pathology, as well as those participating to brain–heart communication, back and forth. We discuss existing literature, providing a comprehensive view of the advancement in the understanding of the mechanisms of neurogenic heart control. In addition, we weigh the limits and potential of optogenetics in basic and applied research in neuro-cardiology.

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“…Implantation of an implantable cardioverter-defibrillator (ICD) for primary prevention of sudden cardiac death (SCD) is indicated in patients with reduced left ventricular function (LVEF ≤ 35%) or for secondary prevention after hemodynamically not tolerable ventricular tachycardia or aborted SCD (5,(7)(8)(9). Patients with HF (10) and/or an ICD (11,12) frequently report depressive symptoms. Patients with HF exhibit depressive symptoms in as high as 41.9% of cases, with 28.1% showing moderate to severe depression (10).…”

Section: Introductionmentioning

confidence: 99%

“…Patients with HF (10) and/or an ICD (11,12) frequently report depressive symptoms. Patients with HF exhibit depressive symptoms in as high as 41.9% of cases, with 28.1% showing moderate to severe depression (10). Depressive symptoms can be detected by selfrating questionnaires such as the Patient Health Questionnaire 9 (PHQ-9), and high PHQ-9 scores have been associated with low quality of life (QoL) and high risk of hospitalization (13).…”

Section: Introductionmentioning

confidence: 99%

Depressive Symptoms and Quality of Life in Patients With Heart Failure and an Implantable Cardioverter-Defibrillator

et al. 2022

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BackgroundHeart failure (HF) is associated with development of depressive symptoms and reduced quality of life (QoL). Patients with HF and an implantable cardioverter-defibrillator (ICD) were evaluated regarding depressive symptoms and QoL.MethodsThe present study included 446 patients with HF and an ICD. Depressive symptoms were assessed using the Patient Health Questionnaire 9 (PHQ-9), QoL was evaluated using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Functional ability and exercise tolerance were assessed at inclusion and after 6 months with help of the 6-min walking test (6MWT).ResultsPatients included in the study had a mean age of 65.8 years and were predominantly male (83.6%), with mostly ischemic (n = 277; 62.1%) or dilated (n = 150; 33.6%) cardiomyopathy. One hundred ninety-three (43.2%) patients had depressive symptoms, of whom 75 patients (16.8%) were classified as moderate to severe depression according to the PHQ-9 at baseline. Depressive symptoms were associated with low QoL independent of NYHA functional class. High NYHA functional class, high PHQ-9 score, age and body mass index (BMI) were associated with a lower 6MWT at enrollment, while depressive symptoms (expressed as higher PHQ-9 score) and age were associated with a lower 6MWT after 6 months. Patients with history of smoking and a higher BMI showed higher PHQ-9 scores after 6 months. Patients under antidepressant medication showed improved PHQ-9 score after 6 months, indicating controlled/treated depression. However, patients with low QoL at inclusion remained with low QoL after 6 months.ConclusionDepressive symptoms correlate with low QoL and lower long-term functional status in patients with HF and an ICD. Depressive symptoms are associated with smoking and obesity, which themselves are risk factors for a poor prognosis in HF. Only a small fraction of patients with HF and ICD showing depressive symptoms receives appropriate treatment. Assessing depressive symptoms and lifestyle factors should be part of a multimodal treatment plan in patients with HF and an ICD.

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Global Prevalence of Depression among Heart Failure Patients: A Systematic Review and Meta-Analysis

Cited by 45 publications

References 22 publications

The Situation-Specific Theory of Heart Failure Self-care

The Situation-Specific Theory of Heart Failure Self-care

Neurohumoral Cardiac Regulation: Optogenetics Gets Into the Groove

Depressive Symptoms and Quality of Life in Patients With Heart Failure and an Implantable Cardioverter-Defibrillator

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