Scott Lundgren1, Cecilia Y M Poon2, Ahmed Selim1, Brian D Lowes1, Ronald Zolty1, Adam Burdorf1, Yael Potashnik-Peled3, Michael J Moulton4, John Y Um4, Eugenia Raichlin5. 1. Division of Cardiology, University of Nebraska Medical Center, Omaha, NE - USA. 2. Psychology Department, Nebraska Medicine, Omaha, NE - USA. 3. Sheba Medical Center Heart Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv - Israel. 4. Department of Cardiothoracic Surgery, University of Nebraska Medical Center, Omaha, NE - USA. 5. Department of Cardiology, Loyola University Medical Center, Maywood, IL - USA.
Abstract
BACKGROUND: Depression and anxiety are associated with a worse prognosis in heart failure patients. The aim of this study was to identify the prevalence of depression and anxiety in left ventricular assist device (LVAD) candidates and assess their effect on post-LVAD outcomes. METHODS: Based on the pre-LVAD psychological assessment, the total cohort of 246 patients were divided into 4 groups: 1) no depression or anxiety (NDep&Anx group, n = 138); 2) isolated depression (Dep group, n = 42); 3) isolated anxiety (Anx group, n = 32), and 4) combined depression and anxiety (Dep&Anx group, n = 34). RESULTS: The Dep&Anx group was associated with higher prevalence of female gender (p = 0.03), higher body mass index (p = 0.03), elevated E/E' (p = 0.003), and increased Model For End-Stage Liver Disease (MELD) XI score (p = 0.04) prior to LVAD as compared to the other 3 subgroups. The prevalence of other major psychiatric disorders (p = 0.03) and narcotic dependence (p = 0.004) was higher in the Dep&Anx group. Post-LVAD implantation, heart rate and filling pressures were elevated and readmission rate was higher (p = 0.001) in the Dep&Anx group. There was no difference in survival between the groups (p = 0.40, Log-Rank test). CONCLUSIONS: Pre-existing anxiety and depression was associated with worse HF pre- and post-LVAD implantation and higher readmissions rate after LVAD implantation.
BACKGROUND:Depression and anxiety are associated with a worse prognosis in heart failurepatients. The aim of this study was to identify the prevalence of depression and anxiety in left ventricular assist device (LVAD) candidates and assess their effect on post-LVAD outcomes. METHODS: Based on the pre-LVAD psychological assessment, the total cohort of 246 patients were divided into 4 groups: 1) no depression or anxiety (NDep&Anx group, n = 138); 2) isolated depression (Dep group, n = 42); 3) isolated anxiety (Anx group, n = 32), and 4) combined depression and anxiety (Dep&Anx group, n = 34). RESULTS: The Dep&Anx group was associated with higher prevalence of female gender (p = 0.03), higher body mass index (p = 0.03), elevated E/E' (p = 0.003), and increased Model For End-Stage Liver Disease (MELD) XI score (p = 0.04) prior to LVAD as compared to the other 3 subgroups. The prevalence of other major psychiatric disorders (p = 0.03) and narcotic dependence (p = 0.004) was higher in the Dep&Anx group. Post-LVAD implantation, heart rate and filling pressures were elevated and readmission rate was higher (p = 0.001) in the Dep&Anx group. There was no difference in survival between the groups (p = 0.40, Log-Rank test). CONCLUSIONS: Pre-existing anxiety and depression was associated with worse HF pre- and post-LVAD implantation and higher readmissions rate after LVAD implantation.
Authors: Quin E Denfeld; Kenneth M Faulkner; Mary Roberts Davis; Beth A Habecker; Christopher V Chien; Jill M Gelow; James O Mudd; Shirin O Hiatt; Kathleen L Grady; Christopher S Lee Journal: Eur J Cardiovasc Nurs Date: 2021-10-27 Impact factor: 3.593
Authors: Jonathan J Edwards; Jonathan B Edelson; Hannah Katcoff; Antara Mondal; Debra Lefkowitz; Nosheen Reza; Thomas C Hanff; Heather Griffis; Jeremy A Mazurek; Joyce Wald; Anjali T Owens; Carol A Wittlieb-Weber; Danielle S Burstein; Pavan Atluri; Matthew J O'Connor; Lee R Goldberg; Payman Zamani; Peter W Groeneveld; Joseph W Rossano; Kimberly Y Lin; Edo Y Birati Journal: Am Heart J Date: 2021-06-03 Impact factor: 5.099
Authors: Mary Amanda Dew; Andrea F DiMartini; Fabienne Dobbels; Kathleen L Grady; Sheila G Jowsey-Gregoire; Annemarie Kaan; Kay Kendall; Quincy-Robyn Young Journal: Curr Heart Fail Rep Date: 2019-12