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Luo YT, Ou AZ, Lin DS, Li H, Zhou F, Liu YM, Ye XP, Deng X. Status of anxiety and depression among chronic heart failure patients: Factors influencing poor fluid restriction adherence. World J Psychiatry 2025; 15:103765. [DOI: 10.5498/wjp.v15.i6.103765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2025] [Revised: 03/27/2025] [Accepted: 04/15/2025] [Indexed: 05/29/2025] Open
Abstract
BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure (CHF) and can adversely contribute to treatment adherence and clinical outcomes. Poor fluid restriction adherence is a widespread challenge in the management of CHF. To effectively manage disease progression and alleviate symptoms, it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.
AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.
METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study. Questionnaires, including the Psychosomatic Symptom Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Fluid Restriction Adherence Questionnaire were administered to patients. Based on their anxiety and depression scores, patients were categorized into anxiety/depression and non-anxiety/depression groups, as well as fluid restriction adherence and fluid restriction non-adherence groups. General patient data were collected, and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety. Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.
RESULTS Statistically significant differences in age, New York Heart Association (NYHA) grading, marital status, educational attainment, and family support were observed between depressed and non-depressed CHF patients (P < 0.05). Age, NYHA grading, marital status, educational attainment, and family support were identified as factors influencing the development of depression. The anxiety and non-anxiety groups differed statistically in terms of gender, age, NYHA grading, smoking history, alcohol consumption history, monthly income, educational attainment, and family support (P < 0.05). Gender, smoking, alcohol consumption, monthly income, and educational attainment affected anxiety in these patients. The fluid restriction adherence rate was 28.0%, and thirst sensation, anxiety, and depression were identified as independent influencing factors.
CONCLUSION CHF patients are susceptible to anxiety and depression, with multiple associated influencing factors. Moreover, anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.
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Affiliation(s)
- Yun-Tao Luo
- Department of Health Management, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
| | - Ai-Zhi Ou
- Department of Health Management, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
| | - Di-Sha Lin
- Department of Health Management, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
| | - Hong Li
- Department of Health Management, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
| | - Fang Zhou
- Department of Health Management, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
| | - Yue-Mei Liu
- Department of Cardiology, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
| | - Xin-Ping Ye
- Department of Health Management, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
| | - Xu Deng
- Preventive Treatment Center, The First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, Hunan Province, China
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Shah A, Shahil Feroz A, Nolan RP, Strudwick G, Sockalingam S, Seto E. Access to mental health services for people living with heart failure: a qualitative study. BMJ Open 2025; 15:e098866. [PMID: 40379321 PMCID: PMC12086933 DOI: 10.1136/bmjopen-2025-098866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2025] [Accepted: 04/17/2025] [Indexed: 05/19/2025] Open
Abstract
OBJECTIVES Amidst low recognition and treatment for mental health conditions among people living with heart failure (PLWHF), this study aimed to identify factors affecting access to mental health services for PLWHF. DESIGN Semi-structured phone interviews were conducted with PLWHF (n=13) and clinicians and researchers (n=9). SETTING Heart failure remote management programme at a large urban academic hospital in Ontario, Canada. RESULTS Using inductive reflexive thematic analysis, 14 themes were created and mapped to Levesque's patient-centred access to care framework, revealing barriers at the system and patient levels. System-level barriers included service approachability (ie, difficulties detecting mental health concerns; unpreparedness for referral conversations), availability and accommodation (ie, limited mental health services; poorly timed services; inconsistent care pathways) and affordability (ie, limited human resources; lack of options for choice or finding fit; insufficiency of generic mental health services). Patient-level barriers included limitations in the ability to perceive mental health needs (ie, low mental health literacy), as well as seek (ie, stigma), reach (ie, inconvenience of in-person delivery) and pay (ie, lack of full insurance coverage and high cost of psychological services) for mental healthcare. CONCLUSIONS The findings suggest enhancing the approachability, availability and appropriateness of mental health services and promoting the ability of PLWHF to recognise their mental health needs as potential interventional targets.
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Affiliation(s)
- Amika Shah
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Centre for Digital Therapeutics, University Health Network, Toronto, Ontario, Canada
| | - Anam Shahil Feroz
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Centre for Digital Therapeutics, University Health Network, Toronto, Ontario, Canada
| | - Robert P Nolan
- Cardiac eHealth, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Gillian Strudwick
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Information Management Group, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sanjeev Sockalingam
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
| | - Emily Seto
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Centre for Digital Therapeutics, University Health Network, Toronto, Ontario, Canada
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Zeng J, Qiu Y, Yang C, Fan X, Zhou X, Zhang C, Zhu S, Long Y, Hashimoto K, Chang L, Wei Y. Cardiovascular diseases and depression: A meta-analysis and Mendelian randomization analysis. Mol Psychiatry 2025:10.1038/s41380-025-03003-2. [PMID: 40247128 DOI: 10.1038/s41380-025-03003-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 03/16/2025] [Accepted: 03/27/2025] [Indexed: 04/19/2025]
Abstract
Depression is a common psychiatric symptom among patients with cardiovascular disease (CVD), adversely affecting their health. Despite the identification of various contributing factors, the precise mechanisms linking CVD and depression remain elusive. This study conducted a meta-analysis to investigate the association between CVD and depression. Furthermore, a bidirectional Mendelian randomization (MR) analysis was undertaken to clarify the causal relationship between the two conditions. The meta-analysis included 39 studies, encompassing 63,444 patients with CVD, 12,308 of whom were diagnosed with depression. The results revealed a significant association between CVD and depression or anxiety, with an estimated overall prevalence of depression in CVD patients of 20.8%. Subgroup analyses showed that the prevalence of depression in patients with coronary artery disease and heart failure was 19.8% and 24.7%, respectively. According to a random-effects model, depressive symptoms were linked to an increase in unadjusted all-cause mortality compared with non-depressed patients. The MR analysis, employing the inverse-variance weighted method as the primary tool for causality assessment, identified significant associations between various CVD types and depression or anxiety phenotypes. These findings underscore the significant relationship between CVD and depression or anxiety, leading to an elevated risk of all-cause mortality. Moreover, the MR analysis provides the first genetically-informed evidence suggesting that depression plays a critical role in the development and progression of certain CVD subtypes. This emphasizes the need for addressing depressive symptoms in CVD patients to prevent or reduce adverse cardiovascular outcomes.
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Affiliation(s)
- Jun Zeng
- Key Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Yuting Qiu
- Key Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Chengying Yang
- Department of Cardiology, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Xinrong Fan
- Department of Cardiology, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Xiangyu Zhou
- Basic Medicine Research Innovation Center for Cardiometabolic Diseases, Ministry of Education, Southwest Medical University, Luzhou, 646000, Sichuan, China
- Department of Thyroid and Vascular Surgery, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Chunxiang Zhang
- Basic Medicine Research Innovation Center for Cardiometabolic Diseases, Ministry of Education, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Yang Long
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, Sichuan, 646000, China
- Experimental Medicine Center, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Kenji Hashimoto
- Basic Medicine Research Innovation Center for Cardiometabolic Diseases, Ministry of Education, Southwest Medical University, Luzhou, 646000, Sichuan, China.
- Chiba University Center for Forensic Mental Health, Chiba, 260-8670, Japan.
| | - Lijia Chang
- Basic Medicine Research Innovation Center for Cardiometabolic Diseases, Ministry of Education, Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Yan Wei
- Key Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, 646000, Sichuan, China.
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Tran PM, Tran HB, Nguyen DV, Pham HM, Do LD, Nguyen HQ, Kirkpatrick JN, Janardhanan R, Reid CM, Nguyen HTT. Quality of Life Among Patients with Heart Failure with Reduced Ejection Fraction Receiving Telemedicine Care in Vietnam. Telemed J E Health 2025; 31:431-440. [PMID: 39582438 DOI: 10.1089/tmj.2024.0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2024] Open
Abstract
Background: Telemedicine is an effective method to monitor patients at home and improve outcomes of heart failure (HF), especially HF with reduced ejection fraction (HFrEF). However, little is known about the impact of telemedicine on the quality of life (QoL) among outpatients with HFrEF in lower-middle-income countries (LMICs). Methods: In this single-center, prospective, randomized, controlled, open, and parallel-group clinical trial in northern Vietnam, patients with HFrEF were allocated to either telemedicine or control groups. Participants in the experimental arm underwent a home-based telemedicine program with regular telephone follow-ups and consultations. Participants in the control group received usual care. Both groups were followed for 6 months. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) score from baseline. The analysis was conducted on an intention-to-treat basis. Results: A total of 223 participants were randomized into two groups-the telemedicine group and the usual care group. Of the 223, 170 patients [mean age: 61.5 ± 15.0 years; female: 122 (71.8%)] completed follow-up and were included in the final analysis (87 in the telemedicine group and 83 in the usual care group). At baseline, the MLHFQ scores were equivalent between the two groups (median [interquartile range]: 81 [73-92] vs. 81 [74-92]; p = 0.992). After 6-month follow-up, the telemedicine group showed greater improvement in MLHFQ total scores than the usual care group (mean change in MLHFQ score: -15.5 ± 14.0 vs. -1.3 ± 6.2; difference in change: -14.2 [95% confidence interval, CI: -17.5, -11.0]; p < 0.0001). Similar results were found for the MLHFQ physical dimension score (difference in change: -5.8 [95% CI: -7.4, -4.1]; p < 0.0001) and the MLHFQ emotional dimension score (difference in change: -3.2 [95% CI: -4.2, -2.2]; p < 0.0001). Conclusions: In this study, a telemedicine intervention significantly improved QoL compared with usual care among patients with HFrEF in an LMIC.
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Affiliation(s)
- Phuong Minh Tran
- Bach Mai Hospital, Vietnam National Heart Institute, Hanoi, Vietnam
| | - Hieu Ba Tran
- Bach Mai Hospital, Vietnam National Heart Institute, Hanoi, Vietnam
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Dung Viet Nguyen
- Bach Mai Hospital, Vietnam National Heart Institute, Hanoi, Vietnam
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Hung Manh Pham
- Bach Mai Hospital, Vietnam National Heart Institute, Hanoi, Vietnam
- Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
| | - Loi Doan Do
- Bach Mai Hospital, Vietnam National Heart Institute, Hanoi, Vietnam
- Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
| | - Ha Quoc Nguyen
- Department of Science and Technology, Hanoi City's People Committee, Hanoi, Vietnam
| | - James N Kirkpatrick
- Department of Medicine, Department of Bioethics and Humanities, Cardiovascular Division, University of Washington Medical Center, Seattle, Washington, USA
| | - Rajesh Janardhanan
- Department of Cardiovascular Medicine, Sarver Heart Center, University of Arizona, Tucson, Arizona, USA
| | - Christopher M Reid
- School of Population Health, Curtin University, Perth, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Hoai Thu Thi Nguyen
- Bach Mai Hospital, Vietnam National Heart Institute, Hanoi, Vietnam
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
- Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam
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Ceran S, Emekli E, Aşut G, Sezgin A. Psychiatric Disorders and Associated Factors in Left Ventricular Assist Device Implantation and Heart Transplant Candidates. Clin Transplant 2025; 39:e70052. [PMID: 39775832 DOI: 10.1111/ctr.70052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2024] [Revised: 10/28/2024] [Accepted: 11/25/2024] [Indexed: 01/11/2025]
Abstract
INTRODUCTION End-stage heart failure (ESHF) remains a significant challenge despite optimal treatment, with heart transplantation (HTx) being the gold standard of care. Mechanical circulatory support (MCS) devices such as left ventricular assist devices (LVADs) are increasingly used for temporary or permanent treatment. Psychiatric comorbidities are common in patients with ESHF and may affect treatment outcomes, but the relationship between sociodemographic, clinical, and psychiatric characteristics remains unclear. METHODS A medical record based, descriptive cross-sectional study was conducted on 94 ESHF patients scheduled for HTx or LVAD therapy. Sociodemographic, clinical, and psychiatric data, including psychiatric diagnoses and systemic inflammatory markers, were collected from medical records. Univariate analyses compared patients with (PD) and without psychiatric disorders (No-PD). RESULTS Of the participants, 37% had active psychopathology, with major depressive disorder (MDD) and generalized anxiety disorder (GAD) being prevalent. Approximately half of those diagnosed received their first psychiatric diagnosis at the time of assessment. Sociodemographic factors did not differ significantly between the PD and No-PD groups. While no significant difference was observed in ejection fraction (%) and inflammatory markers such as C-reactive protein (CRP), lymphocyte count was higher in the PD group. CONCLUSIONS Preoperative psychiatric assessment is crucial to identify psychiatric comorbidities in ESHF patients undergoing HTx or LVAD therapy. Despite limitations, this study sheds light on previously unexplored aspects, such as the relationship between ejection fraction and psychiatric comorbidities and the relationship between depressive symptoms and inflammatory markers obtained from complete blood count. Furthermore, the fact that almost half of the patients with psychiatric comorbidity were first diagnosed during the pre-treatment psychiatric assessment underlines the importance of pre-LVAD and pre-HTX psychiatric evaluation.
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Affiliation(s)
- Selvi Ceran
- Department of Psychiatry, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Esra Emekli
- Department of Psychiatry, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Gonca Aşut
- Department of Psychiatry, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Atilla Sezgin
- Department of Cardiovascular Surgery, Başkent University Faculty of Medicine, Ankara, Turkey
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Zhao Q, Sun X, Zhang Y, Zhang Y, Chen C. Network analysis of anxiety and depressive symptoms among patients with heart failure. BMC Psychiatry 2024; 24:803. [PMID: 39543555 PMCID: PMC11720705 DOI: 10.1186/s12888-024-06259-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 11/05/2024] [Indexed: 11/17/2024] Open
Abstract
BACKGROUND Anxiety and depressive symptoms are common among patients with heart failure (HF). Physical limitations, lifestyle changes, and uncertainties related to HF can result in the development or exacerbating of anxiety and depressive symptoms. However, the central and bridge symptoms of anxiety and depressive symptoms network among patients with HF remain unclear. Network analysis is a statistical method that can discover and visualize complex relationships between multiple variables. This study aimed to establish a network of anxiety and depressive symptoms and identify the central and bridge symptoms in this network among patients with HF. METHODS This study employed a cross-sectional study design and convenience sampling to recruit patients with HF. This study followed the Helsinki Declaration and was approved by the Research Ethics Committee of Hospital. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) were administered to evaluate anxiety and depressive symptoms among patients with HF, respectively. Network analysis of anxiety and depressive symptoms was performed using R. RESULTS In the anxiety and depressive symptoms network, PHQ2 (feeling down, depressed, or hopeless), PHQ7 (inability to concentrate), and GAD4 (difficulty relaxing) were the most central symptoms. Anxiety and depressive symptoms were linked by PHQ2 (feeling down, depressed, or hopeless), GAD6 (becoming easily annoyed or impatient), GAD5 (unable to sit still because of anxiety), GAD7 (feeling afraid that something terrible is about to happen), and PHQ6 (feeling bad or like a failure, or disappointing oneself or family). CONCLUSIONS This study identified the central and bridge symptoms in a network of anxiety and depressive symptoms. Targeting these symptoms can contribute to interventions for patients with HF at risk of-or suffering from-anxiety and depressive symptoms, which can be effective in reducing the comorbidity of anxiety and depression.
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Affiliation(s)
- Qiuge Zhao
- School of Nursing, Shandong Second Medical University, 7166# Baotong Xi Road, Weifang, Shandong, 261053, P. R. China
| | - Xiaofei Sun
- School of Humanities and Design, Zhengzhou Vocational University of Information and Technology, Zhengzhou, Henan, China
| | - Yanting Zhang
- School of Nursing, Zhengzhou Railway Vocational and Technical College, Zhengzhou, Henan, China
| | - Yuzhen Zhang
- School of Nursing, Shandong Second Medical University, 7166# Baotong Xi Road, Weifang, Shandong, 261053, P. R. China
| | - Cancan Chen
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China.
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Chen X, Liang XY, Zhang GL, Wei SY, Zou JX, Liu H, Zhang H. Relationships between heart failure, depression, and anxiety: A Mendelian randomization study. Medicine (Baltimore) 2024; 103:e40005. [PMID: 39432592 PMCID: PMC11495748 DOI: 10.1097/md.0000000000040005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 09/19/2024] [Indexed: 10/23/2024] Open
Abstract
Growing evidence suggests that heart failure (HF) is associated with an increased risk of depressive disorders and anxiety. However, the existing studies were observational and may have confounded and not reflected true causal relationships. This study collected genetic instruments about HF, depression, and anxiety from publicly available genetic summary data. Two-sample Mendelian randomization (MR) analysis was performed, with inverse-variance weighted designated as the primary approach for determining causal effects. Secondary analyses included MR-Egger regression and the weighted media method. Additionally, we conducted MR pleiotropy residual sum and outlier to address horizontal pleiotropy. Cochran Q test, MR-Egger intercept test, and leave-one-out analysis were used to assess the robustness of the findings. The significance is determined by a P-value below .05. Gene prediction result revealed that HF did not exhibit a significant association with elevated incidence of depression by inverse-variance weighted method no matter HF from the Heart Failure Molecular Epidemiology for Therapeutic Targets Consortium (odds ratio [OR] = 1.05, 95% confidence interval [CI] = 0.93-1.18, P = .424 for major depressive disorder, MDD; OR = 1.01, 95% CI = 0.94-1.09, P = .782 for major depression) or the FinnGen Consortium (OR = 1.03, 95% CI = 0.92-1.15, P = .644 for MDD; OR = 1.00, 95% CI = 0.94-1.07, P = .962 for major depression). In contrast, the results of HF on anxiety exhibited inconsistency (OR = 1.60, 95% CI = 1.10-2.31, P = .013 for Heart Failure Molecular Epidemiology for Therapeutic Targets Consortium; OR = 1.42, 95% CI = 0.91-2.21, P = .123 for FinnGen Consortium); however, a combined effect analysis indicated support causal relationship between HF and the risk of anxiety (OR = 1.52, 95% CI = 1.07-2.00, P < .001). Our findings did not reveal evidence to confirm a causal association between HF and depression. However, our results provide support for a causal effect of HF on the risk of anxiety.
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Affiliation(s)
- Xi Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xing-Yu Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Gui-Lin Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shu-Yan Wei
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing-Xia Zou
- Department of Cardiology, Sichuan No. 2 Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hao Liu
- Department of Cardiology, Sichuan No. 2 Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hong Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Pan L, Qiao L, Zhang Y, Zhang J, Yuan L. Effectiveness of Timely Implementation of Palliative Care on the Well-Being of Patients With Chronic Heart Failure: A Randomized Case-Control Study. J Palliat Care 2024; 39:282-288. [PMID: 37357744 DOI: 10.1177/08258597231184798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objectives: To date, there is a lack of consensus on the timely implementation of palliative care (PC) in patients with chronic heart failure (HF). We aimed to investigate the impact of primary PC intervention on chronic HF patients with different classes of cardiac function, and to determine a proper time point for the implementation of primary PC intervention. Methods: A consecutive series of 180 chronic HF patients with the New York Heart Association (NYHA) Cardiac function ranging from I to III were enrolled in this study. Patients with the same cardiac function class, they were randomized and equally assigned to the usual care (UC) group or to the PC intervention group. At the end of 24-week treatment, quality-of-life (QoL) measurements were evaluated. Left ventricular ejection fraction and N-terminal pro-B-type natriuretic peptide were measured for each group at baseline and the final follow-up, respectively. Results: Through the 6-month follow-up, patients randomized to the PC intervention group presented significantly better QoL and cardiac function as compared with patients randomized to the UC group alone. Subgroup analysis showed that for patients with NYHA class II or III, significantly improved cardiac function and QoL were observed in the PC intervention group as compared with the control group. As for patients with class I, no significant difference was found between the 2 groups. Conclusions: Palliative program can effectively improve the QoL and cardiac function of patients with chronic HF. Moreover, we provided evidence on timely referral of patients to PC intervention, which could be beneficial for patients with NYHA class II.
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Affiliation(s)
- Lu Pan
- Department of Geriatrics, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Li Qiao
- Department of Emergency, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yuzhe Zhang
- Department of Psychology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jianwei Zhang
- Department of Geriatrics, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Ling Yuan
- Department of Nursing, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
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Abou Kamar S, Oostdijk B, Andrzejczyk K, Constantinescu A, Caliskan K, Akkerhuis KM, Umans V, Brugts JJ, Boersma E, van Dalen B, Kardys I. Temporal evolution of anxiety and depression in chronic heart failure and its association with clinical outcome. Int J Cardiol 2024; 411:132274. [PMID: 38880425 DOI: 10.1016/j.ijcard.2024.132274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/06/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Although anxiety and depression have been associated with adverse outcomes in chronic heart failure (HF), data on temporal evolution of these symptoms are scarce. We aimed to investigate the association between repeatedly measured depression and anxiety symptoms and clinical outcome in chronic HF patients. METHODS In this prospective observational study, outpatients with chronic HF were included and followed-up for a maximum of 2.5 years. The hospital anxiety and depression scale (HADS) questionnaire was conducted every six months. The primary endpoint was a composite of HF hospitalization, cardiovascular death, heart transplantation and left ventricular assist device (LVAD) implantation. Cox and joint models were used to investigate the association between the HADS score and the endpoint. RESULTS A total of 362 patients filled out a median (25th-75th percentile) of 3 [2-4] questionnaires each. Mean ± SD age was 63 ± 13 years, 72% were men. Anxiety scores remained relatively stable leading up to the endpoint, while depression scores increased. Higher baseline depression scores were significantly associated with the endpoint (hazard ratio [HR] 1.68 and 95% confidence interval [CI] 1.19-2.36 per log(score+1), p = 0.003), while higher baseline anxiety scores did not reach statistical significance (HR [95% CI] 1.34 [0.99-1.83], p = 0.061). When repeatedly measured, both higher anxiety (HR [95% CI] 1.57[1.07-2.30], p = 0.022) and depression (HR [95% CI] 2.04 [1.39-3.06], p < 0.001) scores were significantly associated with the endpoint. CONCLUSION Serial measurements of depression and anxiety symptoms identify chronic HF patients with increased risk of adverse clinical outcomes. Screening for both disorders should be considered in clinical practice.
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Affiliation(s)
- S Abou Kamar
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - B Oostdijk
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - K Andrzejczyk
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - A Constantinescu
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - K Caliskan
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - K M Akkerhuis
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - V Umans
- Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands
| | - J J Brugts
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - E Boersma
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - B van Dalen
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - I Kardys
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
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10
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Meng T, Fei Q, Zhu J, Gu J, Li W, Wu X, Pan G, Lv T, Chen S. Heart failure causally affects the brain cortical structure: a Mendelian randomization study. Front Neurosci 2024; 18:1416431. [PMID: 39148523 PMCID: PMC11324602 DOI: 10.3389/fnins.2024.1416431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/22/2024] [Indexed: 08/17/2024] Open
Abstract
Background The effects of heart failure (HF) on cortical brain structure remain unclear. Therefore, the present study aimed to investigate the causal effects of heart failure on cortical structures in the brain using Mendelian randomization (MR) analysis. Methods We conducted a two-sample MR analysis utilizing genetically-predicted HF trait, left ventricular ejection fraction (LVEF), and N-terminal prohormone brain natriuretic peptide (NT-proBNP) levels to examine their effects on the cortical surface area (SA) and thickness (TH) across 34 cortical brain regions. Genome-wide association study summary data were extracted from studies by Rasooly (1,266,315 participants) for HF trait, Schmidt (36,548 participants) for LVEF, the SCALLOP consortium (21,758 participants) for NT-proBNP, and the ENIGMA Consortium (51,665 participants) for cortical SA and TH. A series of MR analyses were employed to exclude heterogeneity and pleiotropy, ensuring the stability of the results. Given the exploratory nature of the study, p-values between 1.22E-04 and 0.05 were considered suggestive of association, and p-values below 1.22E-04 were defined as statistically significant. Results In this study, we found no significant association between HF and cortical TH or SA (all p > 1.22E-04). We found that the HF trait and elevated NT-proBNP levels were not associated with cortical SA, but were suggested to decrease cortical TH in the pars orbitalis, lateral orbitofrontal cortex, temporal pole, lingual gyrus, precuneus, and supramarginal gyrus. Reduced LVEF was primarily suggested to decrease cortical SA in the isthmus cingulate gyrus, frontal pole, postcentral gyrus, cuneus, and rostral middle frontal gyrus, as well as TH in the postcentral gyrus. However, it was suggested to causally increase in the SA of the posterior cingulate gyrus and medial orbitofrontal cortex and the TH of the entorhinal cortex and superior temporal gyrus. Conclusion We found 15 brain regions potentially affected by HF, which may lead to impairments in cognition, emotion, perception, memory, language, sensory processing, vision, and executive control in HF patients.
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Affiliation(s)
- Tianjiao Meng
- Department of Neurology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, China
| | - Qinwen Fei
- Department of Geriatrics, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, China
| | - Jingying Zhu
- Department of Emergency, Taizhou Hospital, Taizhou, China
| | - Jiayi Gu
- Wenzhou People's Hospital, Wenzhou, China
| | - Weiyu Li
- The First Clinical Medical Institute of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
- Department of Neurology, Second People's Hospital of Yuhuan, Yuhuan, China
| | - Xianhong Wu
- Department of Neurology, Second People's Hospital of Yuhuan, Yuhuan, China
| | - Gonghua Pan
- Department of Neurology, Second People's Hospital of Yuhuan, Yuhuan, China
| | - Tian Lv
- Department of Neurology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, China
| | - Shiqin Chen
- Department of Neurology, Second People's Hospital of Yuhuan, Yuhuan, China
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11
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Yoo HJ, Kim N, Park MK. Patient-centered care for mental health in patients with heart failure in the intensive care unit: A systematic review. Appl Nurs Res 2024; 78:151814. [PMID: 39053991 DOI: 10.1016/j.apnr.2024.151814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/30/2023] [Accepted: 06/25/2024] [Indexed: 07/27/2024]
Abstract
AIM To assess basic data for developing appropriate interventions by examining the effects of patient-centered care (PCC) on the mental health of patients with heart failure in the intensive care unit (ICU). BACKGROUND Patients with heart failure are frequently admitted to ICUs, and ICU stays are associated with prolonged mental health problems. METHODS We conducted a systematic review using the CINAHL, Cochrane Library, Embase, MEDLINE, PsycINFO, and gray literature databases. Inclusion criteria were studies with participants aged ≥18 years with heart failure in the ICU who received a PCC intervention, and studies that described the outcomes for mental health problems. Data were extracted from five selected studies published after 2020 and analyzed. RESULTS PCC is classified into three areas: comprehensive nursing, multidisciplinary disease management, and targeted motivational interviewing with conventional nursing. The two specific areas of focus for PCC regarding mental health were integrated mental healthcare and specific psychological nursing. Specific psychological nursing comprised relationship building, therapeutic communication, relaxation and motivational techniques, active therapeutic cooperation, psychological status evaluation, music therapy, and environmental management. CONCLUSIONS This review provides a distinctive understanding of multidisciplinary and multicomponent PCC interventions for patients with heart failure in the ICU as an effective approach for improving their mental health. Future PCC intervention strategies aimed at patients with heart failure in the ICU should consider their preferences and family participation.
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Affiliation(s)
- Hye Jin Yoo
- College of Nursing, Dankook University, Cheonan, Republic of Korea
| | - Namhee Kim
- Wonju College of Nursing, Yonsei University, Wonju, Republic of Korea.
| | - Min Kyung Park
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
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12
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Mierzyńska A, Jaworska I, Piotrowicz R, Kowalik I, Pencina M, Opolski G, Zareba W, Banach M, Orzechowski P, Główczynska R, Szalewska D, Pluta S, Kalarus Z, Irzmanski R, Piotrowicz E. The Influence of Hybrid Comprehensive Telerehabilitation on Anxiety in Heart Failure Patients: The TELEREH-HF Randomized Clinical Trial. J Clin Psychol Med Settings 2024; 31:403-416. [PMID: 38108961 DOI: 10.1007/s10880-023-09985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
Telerehabilitation for heart failure (HF) patients is beneficial for physical functioning, prognosis, and psychological status. The study aimed at evaluating the influence of hybrid comprehensive telerehabilitation (HCTR) on the level of anxiety in comparison to usual care (UC). The TELEREH-HF study was a multicenter prospective RCT in 850 clinically stable HF participants. Patients underwent clinical examinations, including the assessment of anxiety, at entry and after the 9-week training program (HCTR) or observation (UC). The State-Trait Anxiety Inventory (STAI) was used. 20.3% HCTR and 20.1% UC patients reported high level of anxiety as a state at baseline, with higher STAI results in younger participants (< 63 y.o.) (p = .048 for HCTR; p = .026 for UC). At both stages of the study, patients with lower level of physical capacity (measured by a peak VO2) had shown significantly higher level of anxiety. There were no significant changes in anxiety levels during the 9-week observation for the entire study population, although there were different patterns of change in anxiety (both trait and state) in younger and older groups,with the decrease in younger patients, and the increase-in the older group.Trial registry number NCT02523560 (Clinical Trials.gov), date of registration: August 14, 2015.
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Affiliation(s)
- Anna Mierzyńska
- National Institute of Cardiology, 04-628, Warsaw, Poland.
- Department of Cardiac Surgery, Military Institute of Medicine - National Research Institute, 04-141, Warsaw, Poland.
| | - Izabela Jaworska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Ryszard Piotrowicz
- National Institute of Cardiology, 04-628, Warsaw, Poland
- College of Rehabilitation, 01-234, Warsaw, Poland
| | - Ilona Kowalik
- National Institute of Cardiology, 04-628, Warsaw, Poland
| | - Michael Pencina
- Duke University's School of Medicine, Durham, NC, 27710, USA
| | - Grzegorz Opolski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Wojciech Zareba
- University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Maciej Banach
- Department of Hypertension, Medical University of Łódź, 90-419, Łódź, Poland
| | - Piotr Orzechowski
- Telecardiology Center, National Institute of Cardiology, 04-628, Warsaw, Poland
| | - Renata Główczynska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Dominika Szalewska
- Department of Rehabilitation Medicine, Medical University of Gdańsk, 80-210, Gdańsk, Poland
| | - Sławomir Pluta
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Zbigniew Kalarus
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800, Zabrze, Poland
| | - Robert Irzmanski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Łódź, 90-419, Łódź, Poland
| | - Ewa Piotrowicz
- Telecardiology Center, National Institute of Cardiology, 04-628, Warsaw, Poland
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13
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Mulugeta H, Sinclair PM, Wilson A. Health-related quality of life of people with heart failure in low- and middle-income countries: a systematic review and meta-analysis. Qual Life Res 2024; 33:1175-1189. [PMID: 38070032 DOI: 10.1007/s11136-023-03563-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 04/26/2024]
Abstract
PURPOSE Heart failure is a global health concern and associated with poor health-related quality of life and increased mortality. There is a disproportionate burden on patients and health systems in low- and middle-income countries. This systematic review and meta-analysis estimates the health-related quality of life of people with heart failure in low- and middle-income countries. METHODS A systematic literature search was conducted to identify relevant studies from January 2012 to November 2022 using the following databases: MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, Scopus and JBI EBP database. Study screening, quality appraisal and data extraction were conducted using JBI methodology. A random-effects model was used to perform the meta-analysis. Heterogeneity was assessed using the I2 statistic. All statistical analyses were done in STATA version 17. RESULTS A total of 33 studies with 5612 participants were included in this review. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Short-Form-36 questionnaire (SF-36) were the most used instruments across 19 and 8 studies, respectively. The pooled mean MLHFQ and SF-36 scores using the random-effects model were 46.08 (95% CI 35.06, 57.10) and 41.23 (95% CI 36.63, 45.83), respectively. In a subgroup analysis using both instruments, the highest health-related quality-of-life scores occurred in studies with inpatient participants. CONCLUSION The overall health-related quality of life of people with heart failure in low- and middle-income countries is poor. Strategies should be strategically developed to improve the health-related quality of life of people with heart failure in these countries. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022377781.
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Affiliation(s)
- Henok Mulugeta
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Amhara Region, Ethiopia.
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia.
| | - Peter M Sinclair
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia
| | - Amanda Wilson
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia
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14
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Sentandreu-Mañó T, Deka P, Almenar L, Tomás JM, Ferrer-Sargues FJ, López-Vilella R, Klompstra L, Marques-Sule E. Kinesiophobia and associated variables in patients with heart failure. Eur J Cardiovasc Nurs 2024; 23:221-229. [PMID: 37534763 DOI: 10.1093/eurjcn/zvad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/04/2023]
Abstract
AIMS Patients with heart failure (HF) can exhibit kinesiophobia, an excessive, debilitating, and irrational fear of movement. This study aimed to enhance the understanding of kinesiophobia in patients with HF by analysing associations with the following variables: musculoskeletal pain, quality of life, quality of sleep, functional capacity, disability, frailty, sex, and age. METHODS AND RESULTS In this cross-sectional study, 107 participants were included, with ages ranging from 28 to 97 years (57% men, mean age 73.18 ± 12.68 years). Multiple regression analyses were performed with all variables, including polynomial regressions for variables with a non-linear relationship. Kinesiophobia was significantly correlated (P < 0.01) with musculoskeletal pain, quality of life, quality of sleep, functional capacity, disability, and being at risk of frailty, while age and sex were not statistically significant. Frailty disability and musculoskeletal pain intensity were variables linearly associated with kinesiophobia, while quality of sleep and disability had a non-linear relationship with kinesiophobia. CONCLUSION Kinesiophobia needs to be evaluated and better understood in patients with HF to improve physical activity and exercise adherence. This study found that musculoskeletal pain intensity, quality of sleep, disability, and frailty risk have a significant association with kinesiophobia in patients with HF. Our results suggest multi-dimensional associations of kinesiophobia in patients with HF, which require further examination and understanding.
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Affiliation(s)
- Trinidad Sentandreu-Mañó
- Department of Physiotherapy, Advanced Research Methods Applied to Quality of Life Promotion (ARMAQoL), University of Valencia, Valencia, Spain
| | - Pallav Deka
- College of Nursing, Michigan State University, 1355 Bogue Street, East Lansing C247, MI, USA
| | - Luis Almenar
- Heart Failure and Transplants Unit, Department of Cardiology, University and Polytechnic Hospital La Fe, Valencia, Spain
- CIBERCV, Valencia, Spain
- University of Valencia, Valencia, Spain
| | - José M Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | - Francisco-José Ferrer-Sargues
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Alfara del Patriarca, Valencia, Spain
| | - Raquel López-Vilella
- Heart Failure and Transplants Unit, Department of Cardiology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
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15
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Gerymski R, Latusek-Mierzwa M. Network Analysis of Sexual Well-Being in Women with Heart Failure: The Psychocardiological Perspective. Healthcare (Basel) 2024; 12:817. [PMID: 38667579 PMCID: PMC11050502 DOI: 10.3390/healthcare12080817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Sexuality is an important sphere of every person's life. Sexual dysfunctions and sexual dissatisfaction may also be present in cardiac diseases. Individuals affected by heart failure (HF) deserve special attention since it can be the final stage of many cardiac diseases. Therefore, it is important to verify potential correlates of sexual well-being in individuals with HF. This study was conducted online between 2019 and 2023, and 262 Polish women aged between 18 and 59 years (M = 45.48; SD = 7.65) participated in it. The Short Sexual Well-Being Scale, Depression Anxiety and Stress Scale, Fatigue Assessment Scale, and authors' questionnaire were used. Relationships between tested variables were verified with the use of network analysis performed with the EBICglasso estimator. Centrality assessment showed that sexual well-being had the highest values of betweenness, closeness and degree, followed by fatigue and depression measures. Sexual well-being was negatively related to the number of declared sexual dysfunctions, fatigue, stress and depression levels. Participants' age and HF duration were not related to the sexual well-being of tested women. Multiple additional partial correlations were detected. The obtained results show that sexuality may be a central sphere of life in women with HF and that one's sexuality should not be negated when working with cardiac patients.
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Affiliation(s)
- Rafał Gerymski
- Department of Health Psychology and Quality of Life, Institute of Psychology, Opole University, 45-040 Opole, Poland
| | - Maria Latusek-Mierzwa
- St. Hedwig’s Provincial Specialist Hospital, 45-221 Opole, Poland;
- Doctoral School of the University of Opole, 45-040 Opole, Poland
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16
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IsHak WW, Hamilton MA, Korouri S, Diniz MA, Mirocha J, Hedrick R, Chernoff R, Black JT, Aronow H, Vanle B, Dang J, Edwards G, Darwish T, Messineo G, Collier S, Pasini M, Tessema KK, Harold JG, Ong MK, Spiegel B, Wells K, Danovitch I. Comparative Effectiveness of Psychotherapy vs Antidepressants for Depression in Heart Failure: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2352094. [PMID: 38231511 PMCID: PMC10794938 DOI: 10.1001/jamanetworkopen.2023.52094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/28/2023] [Indexed: 01/18/2024] Open
Abstract
Importance Heart failure (HF) affects more than 6 million adults in the US and more than 64 million adults worldwide, with 50% prevalence of depression. Patients and clinicians lack information on which interventions are more effective for depression in HF. Objective To compare the effectiveness of behavioral activation psychotherapy (BA) vs antidepressant medication management (MEDS) on patient-centered outcomes inpatients with HF and depression. Design, Setting, and Participants This pragmatic randomized comparative effectiveness trial was conducted from 2018 to 2022, including 1-year follow-up, at a not-for-profit academic health system serving more than 2 million people from diverse demographic, socioeconomic, cultural, and geographic backgrounds. Participant included inpatients and outpatients diagnosed with HF and depression, and data were analyzed as intention-to-treat. Data were analyzed from 2022 to 2023. Interventions BA is an evidence-based manualized treatment for depression, promoting engagement in personalized pleasurable activities selected by patients. MEDS involves the use of an evidence-based collaborative care model with care managers providing coordination with patients, psychiatrists, and primary care physicians to only administer medications. Main Outcomes and Measures The primary outcome was depressive symptom severity at 6 months, measured using the Patient Health Questionnaire 9-Item (PHQ-9). Secondary outcomes included physical and mental health-related quality of life (HRQOL), measured using the Short-Form 12-Item version 2 (SF-12); heart failure-specific HRQOL, measured using the Kansas City Cardiomyopathy Questionnaire; caregiver burden, measured with the Caregiver Burden Questionnaire for Heart Failure; emergency department visits; readmissions; days hospitalized; and mortality at 3, 6, and 12 months. Results A total of 416 patients (mean [SD] age, 60.71 [15.61] years; 243 [58.41%] male) were enrolled, with 208 patients randomized to BA and 208 patients randomized to MEDS. At baseline, mean (SD) PHQ-9 scores were 14.54 (3.45) in the BA group and 14.31 (3.60) in the MEDS group; both BA and MEDS recipients experienced nearly 50% reduction in depressive symptoms at 3, 6, and 12 months (eg, mean [SD] score at 12 months: BA, 7.62 (5.73); P < .001; MEDS, 7.98 (6.06); P < .001; between-group P = .55). There was no statistically significant difference between BA and MEDS in the primary outcome of PHQ-9 at 6 months (mean [SD] score, 7.53 [5.74] vs 8.09 [6.06]; P = .88). BA recipients, compared with MEDS recipients, experienced small improvement in physical HRQOL at 6 months (mean [SD] SF-12 physical score: 38.82 [11.09] vs 37.12 [10.99]; P = .04), had fewer ED visits (3 months: 38% [95% CI, 14%-55%] reduction; P = .005; 6 months: 30% [95% CI, 14%-40%] reduction; P = .008; 12 months: 27% [95% CI, 15%-38%] reduction; P = .001), and spent fewer days hospitalized (3 months: 17% [95% CI, 8%-25%] reduction; P = .002; 6 months: 19% [95% CI, 13%-25%] reduction; P = .005; 12 months: 36% [95% CI, 32%-40%] reduction; P = .001). Conclusions and Relevance In this comparative effectiveness trial of BA and MEDS in patients with HF experiencing depression, both treatments significantly reduced depressive symptoms by nearly 50% with no statistically significant differences between treatments. BA recipients experienced better physical HRQOL, fewer ED visits, and fewer days hospitalized. The study findings suggested that patients with HF could be given the choice between BA or MEDS to ameliorate depression. Trial Registration ClinicalTrials.gov Identifier: NCT03688100.
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Affiliation(s)
- Waguih William IsHak
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Michele A. Hamilton
- Smidt Heart Institute, Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Samuel Korouri
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Marcio A. Diniz
- Biostatistics Research Center, Cedars-Sinai Medical Center, Los Angeles, California
| | - James Mirocha
- Biostatistics Research Center, Cedars-Sinai Medical Center, Los Angeles, California
| | - Rebecca Hedrick
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Robert Chernoff
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Harriet Aronow
- Department of Nursing Research, Cedars-Sinai Medical Center, Los Angeles, California
| | - Brigitte Vanle
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jonathan Dang
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Gabriel Edwards
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Tarneem Darwish
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Gabrielle Messineo
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Stacy Collier
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Mia Pasini
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - John G. Harold
- Smidt Heart Institute, Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Michael K. Ong
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Brennan Spiegel
- Division of Health Services Research, Department of Medicine, Cedars-Sinai Health System, Los Angeles, California
| | - Kenneth Wells
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Itai Danovitch
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California
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17
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Skouri HN, Çavuşoğlu Y, Bennis A, Klug E, Ogola EN, Bader F, Bahjet Al Saffar H, Ragy H, Alhumood KA, Abdelhamid M, Birhan Yılmaz M, Tabbalat R. Expert Recommendations to Bridge Gaps in Heart Failure Patient Support in the Middle East and Africa Region. Anatol J Cardiol 2024; 28:2-18. [PMID: 38167796 PMCID: PMC10796245 DOI: 10.14744/anatoljcardiol.2023.3517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/18/2023] [Indexed: 01/05/2024] Open
Abstract
Heart failure (HF) remains a serious health and socioeconomic problem in the Middle East and Africa (MEA). The age-standardized prevalence rate for HF in the MEA region is higher compared to countries in Eastern Europe, Latin America, and Southeast Asia. Also cardiovascular-related deaths remain high compared to their global counterparts. Moreover, in MEA, 66% of HF readmissions are elicited by potentially preventable factors, including delay in seeking medical attention, nonadherence to HF medication, suboptimal discharge planning, inadequate follow-up, and poor social support. Patient support in the form of activation, counseling, and caregiver education has been shown to improve outcomes in patients with HF. A multidisciplinary meeting with experts from different countries across the MEA region was convened to identify the current gaps and unmet needs for patient support for HF in the region. The panel provided insights into the real-world challenges in HF patient support and contributed strategic recommendations for optimizing HF care.
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Affiliation(s)
- Hadi N. Skouri
- Department of Cardiology, Sheikh Shakbout Medical City-Mayo Clinic, Abu Dhabi, United Arab Emirates
| | - Yüksel Çavuşoğlu
- Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Türkiye
| | - Ahmed Bennis
- Department of Cardiology, The Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Eric Klug
- Division of Cardiology, Netcare Sunninghill, Sunward Park Hospitals, School of Clinical Medicine, Faculty of Health Sciences and the University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Elijah N. Ogola
- Department of Internal Medicine and Cardiology, University of Nairobi, Nairobi, Kenya
| | - Feras Bader
- Department of Cardiovascular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Section of Heart Failure and Transplant, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Hilal Bahjet Al Saffar
- International Advisor, RCP for Iraq, Chair, RCP Iraq Members and Fellows Network Head, Scientific Committee, Iraqi Red Crescent Society Iraq, Baghdad, Iraq
| | - Hany Ragy
- Department of Cardiology, National Heart Institute, Cairo, Egypt
| | - Khaldoon A. Alhumood
- Advanced Heart Failure and Transplantation Unit, Chest Diseases Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Magdy Abdelhamid
- Department of Cardiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mehmet Birhan Yılmaz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Türkiye
| | - Ramzi Tabbalat
- Department of Cardiology, Abdali Medical Center, Amman, Jordan
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18
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Mulugeta H, Sinclair PM, Wilson A. Health-related quality of life and its influencing factors among people with heart failure in Ethiopia: using the revised Wilson and Cleary model. Sci Rep 2023; 13:20241. [PMID: 37981652 PMCID: PMC10658178 DOI: 10.1038/s41598-023-47567-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/15/2023] [Indexed: 11/21/2023] Open
Abstract
Heart failure is a challenging public health problem associated with poor health-related quality of life (HRQoL). Data on the quality of life of people with heart failure are limited in Ethiopia. This study aimed to assess the HRQoL and its influencing factors in people with heart failure in Ethiopia. A hospital-based, cross-sectional study design was conducted in the cardiac outpatient clinics of two tertiary-level hospitals in Addis Ababa, Ethiopia. Data were collected from people with heart failure who met the inclusion criteria using an interviewer-administered questionnaire. The HRQoL was measured using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). A multiple linear regression model was fitted to identify factors that influenced HRQoL. All statistical analyses were conducted using STATA version 17 software. A total of 383 people with heart failure participated in the study. The mean age of the participants was 55 years. The MLHFQ score was 48.03±19.73, and 54% of participants had poor HRQoL. Multiple linear regression analysis revealed that age (β= 0.12, 95% CI 0.11, 0.28), diabetes mellitus comorbidity (β= 4.47, 95% CI 1.41, 7.54), social support score (β= - 1.48, 95% CI - 1.93, - 1.03), and depression score (β = 1.74, 95% CI 1.52, 1.96) were significant factors influencing overall HRQoL (p < 0.05). This study found that people in Ethiopia with heart failure had poor HRQoL, influenced by several factors. The findings can help health professionals identify appropriate interventions to improve the HRQoL of people with heart failure.
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Affiliation(s)
- Henok Mulugeta
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Amhara Region, Ethiopia.
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Peter M Sinclair
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Amanda Wilson
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Storer B, Kershaw KA, Braund TA, Chakouch C, Coleshill MJ, Haffar S, Harvey S, Newby JM, Sicouri G, Murphy M. Global Prevalence of Anxiety in Adult Cardiology Outpatients: A Systematic Review and Meta-analysis. Curr Probl Cardiol 2023; 48:101877. [PMID: 37336306 DOI: 10.1016/j.cpcardiol.2023.101877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
Anxiety and anxiety disorders are associated with adverse cardiovascular outcomes, and reduced quality of life. Despite this, no comprehensive study on the global prevalence of anxiety symptoms and disorders among adult cardiology outpatients exists. This systematic review and meta-analysis aims to provide cardiologists with a precise estimate of the prevalence of anxiety in their outpatient clinics. PubMed, Embase, Cochrane and PsycINFO databases and Google Scholar were searched from database inception to January 23, 2023. Data characteristics were extracted independently by 2 investigators. Ninety-three studies, n = 36,687 participants across 31 countries, were included. Global prevalence of anxiety symptoms/disorders was 28.9% (95%CI 25.7-32.4; 8927/36, 687; I2 = 97.33; n = 93). The highest rates were found in patients presenting with hypertension, 43.6%. Subgroup analyses revealed higher prevalence estimates when using self-report screening compared to gold-standard diagnostic interview. When using diagnostic interview, the highest rates were reported in outpatients with undifferentiated chest pain/palpitations, 19·0%. Panic disorder was the most frequent diagnosis 15.3%, and rates were significantly higher in patients with undifferentiated chest pain/palpitations compared to ischemic heart disease. Higher rates of anxiety were found in studies of outpatients from developing countries, and female outpatients tended to have higher rates compared to males. Anxiety occurred frequently among cardiology outpatients and at a higher rate than estimated in the general population. Given the impact anxiety has on patient outcomes, it is important that effective identification and management strategies be developed to support cardiologists in identifying and treating these conditions in their clinics.
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Affiliation(s)
- Ben Storer
- The Black Dog Institute, Sydney, Australia
| | | | - Taylor A Braund
- The Black Dog Institute, Sydney, Australia; Psychiatry and Mental Health Department, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | | | | | - Sam Haffar
- The Black Dog Institute, Sydney, Australia
| | - Samuel Harvey
- The Black Dog Institute, Sydney, Australia; Psychiatry and Mental Health Department, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Jill M Newby
- The Black Dog Institute, Sydney, Australia; School of Psychology, Faculty of Science, University of New South Wales, Sydney, Australia
| | - Gemma Sicouri
- The Black Dog Institute, Sydney, Australia; School of Psychology, Faculty of Science, University of New South Wales, Sydney, Australia
| | - Michael Murphy
- The Black Dog Institute, Sydney, Australia; Psychiatry and Mental Health Department, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
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20
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Rashid S, Qureshi AG, Noor TA, Yaseen K, Sheikh MAA, Malik M, Malik J. Anxiety and Depression in Heart Failure: An Updated Review. Curr Probl Cardiol 2023; 48:101987. [PMID: 37473952 DOI: 10.1016/j.cpcardiol.2023.101987] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Abstract
Anxiety and depression are commonly experienced by individuals with heart conditions, significantly impacting their overall well-being and prognosis. This review aims to provide an updated examination of the relationship between anxiety, depression, and heart disease. The review begins by exploring the prevalence of anxiety and depression in heart patients, highlighting the substantial rates at which these mental health disorders co-occur in this population. It further elucidates the risk factors that contribute to the development and exacerbation of anxiety and depression in individuals with heart conditions, including biological, psychological, and social factors. The impact of anxiety and depression on cardiac outcomes is a central focus of this review. It explores the intricate bi-directional relationship between mental health and cardiovascular health, discussing the mechanisms through which anxiety and depression can lead to adverse cardiac events and worsen existing heart conditions. Additionally, it examines the potential impact of anxiety and depression on treatment adherence, lifestyle modifications, and overall quality of life in heart patients. The review also investigates the diagnostic and assessment methods for anxiety and depression in heart patients, emphasizing the importance of implementing comprehensive screening protocols in clinical settings. In conclusion, this updated review provides valuable insights into the prevalence, impact, assessment, and management of anxiety and depression in heart patients. It underscores the importance of recognizing and addressing these mental health disorders within the context of cardiac care, ultimately aiming to enhance the overall well-being and prognosis of individuals living with heart conditions.
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Affiliation(s)
- Sarim Rashid
- Department of General Surgery, East Lancashire NHS Trust Hospital, Lancashire, UK
| | | | | | - Khizer Yaseen
- Department of Medicine, Hamdard College of Medicine and Dentistry, Karachi, Pakistan
| | | | - Maria Malik
- Department of Business Management, Bahria University, Islamabad, Pakistan
| | - Jahanzeb Malik
- Department of Cardiovascular Medicine, Cardiovascular Analytics Group, Islamabad, Pakistan.
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21
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Veskovic J, Cvetkovic M, Tahirovic E, Zdravkovic M, Apostolovic S, Kosevic D, Loncar G, Obradovic D, Matic D, Ignjatovic A, Cvetkovic T, Posch MG, Radenovic S, Ristić AD, Dokic D, Milošević N, Panic N, Düngen HD. Depression, anxiety, and quality of life as predictors of rehospitalization in patients with chronic heart failure. BMC Cardiovasc Disord 2023; 23:525. [PMID: 37891464 PMCID: PMC10612261 DOI: 10.1186/s12872-023-03500-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/06/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Chronic heart failure (CHF) is a severe condition, often co-occurring with depression and anxiety, that strongly affects the quality of life (QoL) in some patients. Conversely, depressive and anxiety symptoms are associated with a 2-3 fold increase in mortality risk and were shown to act independently of typical risk factors in CHF progression. The aim of this study was to examine the impact of depression, anxiety, and QoL on the occurrence of rehospitalization within one year after discharge in CHF patients. METHODS 148 CHF patients were enrolled in a 10-center, prospective, observational study. All patients completed two questionnaires, the Hospital Anxiety and Depression Scale (HADS) and the Questionnaire Short Form Health Survey 36 (SF-36) at discharge timepoint. RESULTS It was found that demographic and clinical characteristics are not associated with rehospitalization. Still, the levels of depression correlated with gender (p ≤ 0.027) and marital status (p ≤ 0.001), while the anxiety values were dependent on the occurrence of chronic obstructive pulmonary disease (COPD). However, levels of depression (HADS-Depression) and anxiety (HADS-Anxiety) did not correlate with the risk of rehospitalization. Univariate logistic regression analysis results showed that rehospitalized patients had significantly lower levels of Bodily pain (BP, p = 0.014), Vitality (VT, p = 0.005), Social Functioning (SF, p = 0.007), and General Health (GH, p = 0.002). In the multivariate model, poor GH (OR 0.966, p = 0.005) remained a significant risk factor for rehospitalization, and poor General Health is singled out as the most reliable prognostic parameter for rehospitalization (AUC = 0.665, P = 0.002). CONCLUSION Taken together, our results suggest that QoL assessment complements clinical prognostic markers to identify CHF patients at high risk for adverse events. CLINICAL TRIAL REGISTRATION The study is registered under http://clinicaltrials.gov (NCT01501981, first posted on 30/12/2011), sponsored by Charité - Universitätsmedizin Berlin.
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Affiliation(s)
- Jovan Veskovic
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, 13353, Berlin, Germany.
- Scirent Clinical Research and Science, 13353, Berlin, Germany.
| | - Mina Cvetkovic
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, 13353, Berlin, Germany
| | - Elvis Tahirovic
- Scirent Clinical Research and Science, 13353, Berlin, Germany
| | - Marija Zdravkovic
- Department of Cardiology, Faculty of Medicine, University Clinical Hospital Center Bezanijska Kosa, University of Belgrade, Belgrade, 11000, Serbia
| | - Svetlana Apostolovic
- Department for Cardiovascular Diseases, Clinical Centre Niš, University of Niš, Niš, 18000, Serbia
| | - Dragana Kosevic
- Institute for Cardiovascular Diseases Dedinje, Department of Cardiology, Belgrade, 11000, Serbia
| | - Goran Loncar
- Institute for Cardiovascular Diseases Dedinje, Department of Cardiology, Belgrade, 11000, Serbia
- Faculty of Medicine, Department of Cardiology, University of Belgrade, University Clinical Center of Serbia, Belgrade, 11000, Serbia
| | - Danilo Obradovic
- Heart Center of Leipzig, University of Leipzig, 04289, Leipzig, Germany
| | - Dragan Matic
- Department of Cardiology, University Clinical Centre of Serbia, Belgrade, 11000, Serbia
| | | | | | | | - Sara Radenovic
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, 13353, Berlin, Germany
| | - Arsen D Ristić
- Faculty of Medicine, Department of Cardiology, University of Belgrade, University Clinical Center of Serbia, Belgrade, 11000, Serbia
| | - Danilo Dokic
- Scirent Clinical Research and Science, 13353, Berlin, Germany
| | - Nenad Milošević
- Scirent Clinical Research and Science, 13353, Berlin, Germany
| | - Natasa Panic
- Scirent Clinical Research and Science, 13353, Berlin, Germany
| | - Hans-Dirk Düngen
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, 13353, Berlin, Germany.
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 13353, Berlin, Germany.
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22
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Li Y, Cen J, Wu J, Tang M, Guo J, Hang J, Zhao Q, Zhao G, Huang X, Han B. The Degree of Anxiety and Depression in Patients With Cardiovascular Diseases as Assessed Using a Mobile App: Cross-Sectional Study. J Med Internet Res 2023; 25:e48750. [PMID: 37792455 PMCID: PMC10585437 DOI: 10.2196/48750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/12/2023] [Accepted: 09/07/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Depression and anxiety are common comorbidities in cardiovascular clinic outpatients. Timely identification and intervention of these mental and psychological disorders can contribute to correct diagnosis, better prognosis, less medical expenses, and improved quality of life. The convenience of online doctor-patient communication platforms has increasingly attracted patients to online consultations. However, online health care and offline health care are very different. Research on how to identify psychological disorders in patients who engage in an online cardiology consultation is lacking. OBJECTIVE This study aimed to explore the feasibility of using a self-rating scale to assess mental illness among patients who consult with a cardiologist online and to compare the differences in anxiety and depression between online and offline patients. METHODS From June 2022 to July 2022, we conducted follow-up visits with 10,173 patients on the Haodf platform. We conducted detailed consultations with 286 patients who visited the same cardiologist in the outpatient department. We used the self-rated Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) scales to assess anxiety and depression, respectively. We analyzed the influencing factors related to the degree of coordination of online patients. We also compared the prevalence of anxiety or depression between online and offline patients and analyzed the factors related to anxiety or depression. RESULTS Of the 10,173 online consultation patients, only 186 (1.8%) responded effectively. The response rate of the offline consultation patients was 96.5% (276/286). Frequent online communication and watching live video broadcasts were significantly related to effective responses from online patients (P<.001). The prevalence of anxiety (70/160, 43.7% vs 69/266, 25.8%; P<.001) or depression (78/160, 48.7% vs 74/266, 27.7%; P<.001) in online consultation patients was significantly higher than that in offline patients. In bivariate analyses, the factors related to anxiety included female sex, unemployment, no confirmed cardiovascular disease, and the online consultation mode, while smokers and those who underwent COVID-19 quarantine were less likely to present with anxiety. The factors related to depression included female sex, divorced or separated individuals, and the online consultation mode. COVID-19 quarantine was related with a lower likelihood of depression. BMI was negatively correlated with depression. In multiple ordered logistic regression analysis, women were more likely than men to present with anxiety (odds ratio [OR] 2.181, 95% CI 1.365-3.486; P=.001). Women (OR 1.664, 95% CI 1.082-2.559; P=.02) and online patients (OR 2.631, 95% CI 1.305-5.304; P=.007) were more likely to have depression. CONCLUSIONS Online patients had more anxiety or depression than offline patients. Anxiety was more prevalent in women, the unemployed, and those without confirmed cardiovascular disease. Women and divorced or separated individuals were more prone to depression. Increasing the frequency of doctor-patient communication and participating in video interactions can help improve patient cooperation.
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Affiliation(s)
- Yongguang Li
- Department of Cardiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Hospital Operation Research, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Jue Cen
- Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junxia Wu
- Department of Comprehensive Statistics, Affiliated Nantong Hospital 3 of Nantong University, Nantong, China
| | - Min Tang
- Department of Cardiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingyi Guo
- Department of Clinical Research Center, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingyu Hang
- Department of Cardiology, Shanghai United Family Hospital, Shanghai, China
| | - Qing Zhao
- Department of Cardiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Zhao
- Department of Cardiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoli Huang
- Department of Cardiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Beibei Han
- Department of Cardiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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23
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Hassanein M, Tageldien A, Badran H, Samir H, Elshafey WE, Hassan M, Magdy M, Louis O, Abdel‐Hameed T, Abdelhamid M. Current status of outpatient heart failure management in Egypt and recommendations for the future. ESC Heart Fail 2023; 10:2788-2796. [PMID: 37559352 PMCID: PMC10567665 DOI: 10.1002/ehf2.14485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 05/27/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023] Open
Abstract
Heart failure (HF) represents one of the greatest healthcare burdens worldwide, and Egypt is no exception. HF healthcare programmes in Egypt still require further optimization to enhance diagnosis and management of the disease. Development of specialized HF clinics (HFCs) and their incorporation in the healthcare system is expected to reduce HF hospitalization and mortality rates and improve quality of care in Egypt. We conducted a literature search on PubMed on the requirements and essential infrastructure of HFCs. Retrieved articles deemed relevant were discussed by a panel of 10 expert cardiologists from Egypt and a basic HFC model for the Egyptian settings was proposed. A multidisciplinary team managing the HFC should essentially be composed of specialized HF cardiologists and nurses, clinical pharmacists, registered nutritionists, physiotherapists, and psychologists. Other clinical specialists should be included according to patients' needs and size and structure of individual clinics. HFCs should receive patients referred from primary care settings, emergency care units, and physicians from different specialties. A basic HFC should have the following fundamental investigations available: resting electrocardiogram, basic transthoracic echocardiogram, and testing for N-terminal pro-B-type natriuretic peptide. Fundamental patients' functional assessments are assessing the New York Heart Association functional classification and quality of life and conducting the 6 min walking test. guideline-directed medical therapy should be implemented, and device therapy should be utilized when available. In the first visit, once HF is diagnosed and co-morbidities assessed, guideline-directed medical therapy should be started immediately. Comprehensive patient education sessions should be delivered by HF nurses or clinical pharmacists. The follow-up visit should be scheduled during the initial visit rather than over the phone, and time from the initial visit to the first follow-up visit should be determined based on the patient's health status and needs. Home and virtual visits are only recommended in limited and emergency situations. In this paper, we provide a practical and detailed review on the essential components of HFCs and propose a preliminary model of HFCs as part of a comprehensive HF programme model in Egypt. We believe that other low-to-middle income countries could also benefit from our proposed model.
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24
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Shimanda PP, Söderberg S, Iipinge SN, Lindholm L, Shidhika FF, Norström F. Health-related quality of life and healthcare consultations among adult patients before and after diagnosis with rheumatic heart disease in Namibia. BMC Cardiovasc Disord 2023; 23:456. [PMID: 37704961 PMCID: PMC10500941 DOI: 10.1186/s12872-023-03504-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/07/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Rheumatic Heart Disease (RHD) causes high morbidity and mortality rates among children and young adults, impacting negatively on their health-related quality of life (HRQoL). This study aimed to evaluate the HRQoL and healthcare consultations of adult patients with RHD in Namibia. METHODS From June 2019 to March 2020, a questionnaire was administered to 83 RHD patients during routine follow-ups. The EQ-5D-5L instrument was used to assess the health-related quality of life before diagnosis and at the time of the survey. The Ethiopian value set for EQ-5D-5L was used to calculate Quality-Adjusted Life Years (QALY). RESULTS Most respondents were women (77%), young adults below the age of 30 years (42%), and individuals who grew up in rural areas (87%). The mean QALY statistically significantly improved from 0.773 pre-diagnosis to 0.942 in the last 12 months (p < 0.001). Sixty-six patients who had surgery reported a better QALY. Healthcare visits statistically significantly increased from on average 1.6 pre-diagnosis to 2.7 days in the last 12 months (p < 0.001). The mean distance to the nearest facility was 55 km, mean cost of transport was N$65, and mean time spent at the clinic was 3.6 h. The median time from diagnosis to the survey was 7 years (quartiles 4 and 14 years). CONCLUSION Treatment and surgery can improve HRQoL substantially among RHD patients. Being diagnosed with RHD affects patients living in socioeconomically disadvantaged rural areas through cost and time for healthcare visits. It would be valuable with further research to understand differences between disease severities.
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Affiliation(s)
- Panduleni Penipawa Shimanda
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, SE, Sweden.
- Clara Barton School of Nursing, Welwitchia Health Training Centre, Pelican Square, P.O. Box 1835, Windhoek, Namibia.
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Umeå University, 901 87, Cardiology, Umeå, SE, Sweden
| | - Scholastika Ndatinda Iipinge
- Clara Barton School of Nursing, Welwitchia Health Training Centre, Pelican Square, P.O. Box 1835, Windhoek, Namibia
| | - Lars Lindholm
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, SE, Sweden
| | | | - Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, SE, Sweden
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25
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Nagy B, Pál-Jakab Á, Kiss B, Orbán G, Sélley TL, Dabasi-Halász Z, Móka BB, Gellér L, Merkely B, Zima E. Remote Management of Patients with Cardiac Implantable Electronic Devices during the COVID-19 Pandemic. J Cardiovasc Dev Dis 2023; 10:214. [PMID: 37233181 PMCID: PMC10219157 DOI: 10.3390/jcdd10050214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023] Open
Abstract
Remote monitoring (RM) is the newest function of cardiac implantable electronic devices (CIEDs). In our observational retrospective analysis, we aimed to assess whether telecardiology could be a safe alternative to routine outpatient examinations during the COVID-19 pandemic. The in- and outpatient visits, the number of acute cardiac decompensation episodes, the RM data from CIEDs, and general condition were examined via questionnaires (KCCQ, EQ-5D-5L). Regarding the enrolled 85 patients, the number of personal patient appearances was significantly lower in the year following the pandemic outbreak compared to the previous year (1.4 ± 1.4 and 1.9 ± 1.2, p = 0.0077). The number of acute decompensation events was five before and seven during lockdown (p = 0.6). Based on the RM data, there was no significant difference in heart failure (HF) markers (all related p > 0.05); only patient activity increased after restrictions were lifted compared to that before the lockdown (p = 0.03). During restrictions, patients reported increased anxiety and depression compared to their previous state (p < 0.001). There was no subjective change in the perception of HF symptoms (p = 0.7). Based on the subjective perception and CIED data, the quality of life of patients with CIED did not deteriorate during the pandemic, but their anxiety and depression intensified. Telecardiology may be a safe alternative to routine inpatient examination.
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Affiliation(s)
- Bettina Nagy
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary
| | - Ádám Pál-Jakab
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary
| | - Boldizsár Kiss
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary
| | - Gábor Orbán
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary
| | | | - Zsigmond Dabasi-Halász
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary
| | - Barbara Bernadett Móka
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary
| | - László Gellér
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary
| | - Endre Zima
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, 1122 Budapest, Hungary
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26
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Al Shamiri MQ, Almushawah AA, Alsomali AH, Alsuwayegh MB, Aljaffer MA, Hayajneh AM, Prajjwal P. The Prevalence of Depression and Anxiety in Heart Failure Patients in Saudi Arabia: An Original Study. Cureus 2023; 15:e36997. [PMID: 37139016 PMCID: PMC10150573 DOI: 10.7759/cureus.36997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
Background Depression is a severe comorbidity that is often detected in patients with chronic diseases. Poor prognosis may eventuate high mortality risk. Up to 30% of heart failure patients have been documented with depression and the majority upholds depression-related symptoms that may have serious clinical implications, such as hospital readmissions and fatalities. To mitigate depression-induced harms among heart failure patients, studies are being conducted to determine the prevalence, risk factors, and interventions. Objectives The current investigation is envisioned to examine the prevalence of depression and anxiety among the Saudi heart failure population. Also, it will help to explore the risk factors that will subsequently facilitate the analysis of preventive measures. Methodology The cross-sectional epidemiologic research was conducted at King Khalid University, Hospital with the recruitment of 205 participants. Each participant underwent a 30-question screening for depression, anxiety, and related risk factors. The "Hospital, Anxiety, and Depression Scale" (HADS score) was used to score subjects for the assessment of both comorbidities. The data points were subsequently analyzed by descriptive statistics and regression analysis. Results Among 205 participants, 137 (66.82%) were male and 68 (33.17%) were female with a mean age of 59.71 years. Our sample reflects a prevalence of 52.7% depression and 56.9% anxiety in Saudi heart failure patients. High depression scores were positively related to age, female gender, hospital readmissions, and pre-existing comorbidities in heart failure patients. Conclusion The study manifested high depression scores among the Saudi heart failure cohort compared to the previous survey. In addition, a substantial interrelationship of depression and categorical variables has been identified that accentuates predominating risks that can potentially promote depression and anxiety in heart failure patients.
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27
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Zannad F, Alikhaani J, Alikhaani S, Butler J, Gordon J, Jensen K, Khatib R, Mantovani L, Martinez R, Moore WF, Murakami M, Roessig L, Stockbridge N, Van Spall HGC, Yancy C, Spertus JA. Patient-reported outcome measures and patient engagement in heart failure clinical trials: multi-stakeholder perspectives. Eur J Heart Fail 2023; 25:478-487. [PMID: 36924142 DOI: 10.1002/ejhf.2828] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/18/2023] Open
Abstract
There are many consequences of heart failure (HF), including symptoms, impaired health-related quality of life (HRQoL), and physical and social limitations (functional status). These have a substantial impact on patients' lives, yet are not routinely captured in clinical trials. Patient-reported outcomes (PROs) can quantify patients' experiences of their disease and its treatment. Steps can be taken to improve the use of PROs in HF trials, in regulatory and payer decisions, and in patient care. Importantly, PRO measures (PROMs) must be developed with involvement of patients, family members, and caregivers from diverse demographic groups and communities. PRO data collection should become more routine not only in clinical trials but also in clinical practice. This may be facilitated by the use of digital tools and interdisciplinary patient advocacy efforts. There is a need for standardization, not only of the PROM instruments, but also in procedures for analysis, interpretation and reporting PRO data. More work needs to be done to determine the degree of change that is important to patients and that is associated with increased risks of clinical events. This 'minimal clinically important difference' requires further research to determine thresholds for different PROMs, to assess consistency across trial populations, and to define standards for improvement that warrant regulatory and reimbursement approvals. PROs are a vital part of patient care and drug development, and more work should be done to ensure that these measures are both reflective of the patient experience and that they are more widely employed.
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Affiliation(s)
- Faiez Zannad
- Université de Lorraine, Inserm Clinical Investigation Center at Institut Lorrain du Coeur et des Vaisseaux, University Hospital of Nancy, Nancy, France
| | | | | | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jason Gordon
- HEOR- Health Economics and Outcomes Research, Ltd, Cardiff, UK
| | | | - Rani Khatib
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds; Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Lorenzo Mantovani
- Value-Based Healthcare Unit, IRCCS Multimedica Hospital, Milan, Italy
| | | | - Wanda F Moore
- Sarver Heart Center Women's Heart Health Education Comm., University of Arizona, Tucson, AZ, USA
| | | | - Lothar Roessig
- Clinical Development Group, Bayer AG, Leverkusen, Germany
| | - Norman Stockbridge
- Division of Cardiology and Nephrology, Food and Drug Administration Center for Drug Evaluation and Research, Silver Spring, MD, USA
| | - Harriette G C Van Spall
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Research Institute of St. Joseph's, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Clyde Yancy
- Department of Internal Medicine, Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - John A Spertus
- Department of Cardiology, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA
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Yan H, Yang J, Luo C, Zhang L, Tian Y, Cui S, Wu J, Chu J. Development and Psychometric Assessment of the Benefit Finding Scale for Chinese Older Adults With Chronic Diseases. Res Gerontol Nurs 2023; 16:44-52. [PMID: 36692437 DOI: 10.3928/19404921-20230105-03] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The current study sought to develop an instrument for measuring benefit finding in Chinese older adults with chronic diseases and establish its psychometric characteristics. Scale items were drafted based on a literature review, theoretical learning, the Benefit Finding Scale (BFS), the Post-Traumatic Growth Inventory, and results of interviews with 24 older adults with chronic diseases. The preliminary scale draft was constructed by performing a Delphi expert consultation and pretest with a small sample. Using the first draft of the scale, we surveyed 380 older adults with chronic diseases. The BFS for older adults with chronic diseases comprised 26 items. Using exploratory factor analysis, we identified six common factors that explained 66.86% of the variance. Item content validity index ranged from 0.818 to 1.000 and scale content validity index was 0.91. Cronbach's alpha of the scale was 0.924 and test-retest reliability was 0.902. The BFS for older adults with chronic diseases showed good validity and reliability and can be used as a measurement tool for benefit finding in the aforementioned population. [Research in Gerontological Nursing, 16(1), 44-52.].
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Sumaqa YA, Hayajneh FA, Alhamory S, Rayan A, Alnaeem M, Al Tarawneh TR, Assaf Alrida NA, Abu-abbas M, Suhemat A, Ayasreh IR. Consequences of Psychological Aspects: From Jordanian Heart Failure Patients' Beliefs. SAGE Open Nurs 2023; 9:23779608231189128. [PMID: 37528905 PMCID: PMC10387668 DOI: 10.1177/23779608231189128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Psychological aspects are common in patients with heart failure (HF). Psychological aspects have negative consequences in patients with HF. Objective This study was conducted to gain a deeper understanding of the consequences of psychological aspects in Jordanian patients with HF. Methods This study is a qualitative study conducted with the participation of 24 patients with HF. Data were collected using semi-structured interviews. Results The main theme of the findings can be expressed as "Consequences of psychological aspects of HF." The following four sub-themes emerged from the data: social isolation, disturbance of feelings, being non-compliant, and growing burden on the health care system. Conclusion The findings revealed the need for informing healthcare providers about the negative consequences of psychological aspects and develop clinical guidelines to evaluate psychological aspects to support these patients.
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Affiliation(s)
| | | | | | - Ahmad Rayan
- Faculty of Nursing, Zarqa University, Zarqa, Jordan
| | | | | | | | | | - Aida Suhemat
- Faculty of Nursing, University of Mutah, Alkarak, Jordan
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Lam MI, Chen P, Xie XM, Lok GKI, Liu YF, Si TL, Ungvari GS, Ng CH, Xiang YT. Heart failure and depression: A perspective from bibliometric analysis. Front Psychiatry 2023; 14:1086638. [PMID: 36937736 PMCID: PMC10017737 DOI: 10.3389/fpsyt.2023.1086638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/02/2023] [Indexed: 03/06/2023] Open
Abstract
Background Depression commonly occurs in heart failure patients, and negatively influences quality of life and disease prognosis. This study explored heart failure and depression-related research from a bibliometric perspective. Methods Relevant publications were searched on June 24, 2022. The Bibliometrix package in R was used to conduct quantitative analyses including the trends in publications, and related countries, articles, authors and keywords. VOSviewer software was used to conduct the visualization map on co-word, co-author, and institution co-authorship analyses. CiteSpace software was used to illustrate the top keywords with citation burst. Results A total of 8,221 publications in the heart failure and depression-related research field were published between 1983 and 2022. In this field, the United States had the most publications (N = 3,013; 36.65%) and highest total citation (N = 149, 376), followed by China, Germany, Italy and Japan. Author Moser and Duke University were the most productive author and institution, respectively. Circulation is the most influential journal. Apart from "heart failure" and "depression," "quality of life," "mortality" and "myocardial infarction" were the most frequently used keywords in this research area; whereas more recently, "self care" and "anxiety" have been used more frequently. Conclusion This bibliometric analysis showed a rapid growth of research related to heart failure and depression from 1989 to 2021, which was mostly led by North America and Europe. Future directions in this research area include issues concerning self-care and anxiety about heart failure. As most of the existing literature were published in English, publications in other languages should be examined in the future.
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Affiliation(s)
- Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
- Kiang Wu Nursing College of Macau, Macao, Macao SAR, China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Xiao-Meng Xie
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | | | - Yu-Fei Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
| | - Gabor S. Ungvari
- University of Notre Dame Australia, Fremantle, WA, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia /Graylands Hospital, Perth, WA, Australia
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
- *Correspondence: Chee H. Ng,
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
- Yu-Tao Xiang,
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Manolis TA, Manolis AA, Melita H, Manolis AS. Neuropsychiatric disorders in patients with heart failure: not to be ignored. Heart Fail Rev 2022:10.1007/s10741-022-10290-2. [DOI: 10.1007/s10741-022-10290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
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Schmitt J, Wenzel B, Brüsehaber B, Anguera I, de Sousa J, Nölker G, Bulava A, Marques P, Hatala R, Golovchiner G, Meyhöfer J, Ilan M. Impact of lockdown during COVID-19 pandemic on physical activity and arrhythmia burden in heart failure patients. Pacing Clin Electrophysiol 2022; 45:471-480. [PMID: 34997979 DOI: 10.1111/pace.14443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/26/2021] [Accepted: 01/02/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Restricted outdoor activity during COVID-19 related lockdown may accelerate heart failure (HF) progression and thereby increase cardiac arrhythmias. We analyzed the impact of March/April 2020 lockdown on physical activity and arrhythmia burden in HF patients treated with cardiac resynchronization therapy (CRT) devices with daily, automatic remote monitoring (RM) function. METHODS The study cohort included 405 HF patients enrolled in Observation of Clinical Routine Care for Heart Failure Patients Implanted with BIOTRONIK CRT Devices (BIO|STREAM.HF) registry in 16 countries, who had left ventricular ejection fraction (LVEF) ≤40% (mean 28.2 ± 6.6%) and NYHA class II/III/IV (47.9%/49.6%/2.5%) before CRT pacemaker/defibrillator implantation. The analyzed RM data comprised physical activity detected by accelerometer, mean heart rate and nocturnal rate, PP variability, percentage of biventricular pacing, atrial high rate episode (AHRE) burden, ventricular extrasystoles and tachyarrhythmias, defibrillator shocks, and number of implant interrogations (i.e., follow-ups). Intraindividual differences in RM parameters before (4-week period) versus during (4-week period) lockdown were tested for statistical significance and independent predictors were identified. RESULTS There was a significant relative change in activity (mean -6.5%, p < .001), AHRE burden (+17%, p = .013), and follow-up rate (-75%, p < .001) during lockdown, with no significant changes in other RM parameters. Activity decreased by ≥8 min/day in 46.5% of patients; predictors were higher LVEF, lower NYHA class, no defibrillator indication, and more activity before lockdown. AHRE burden increased by ≥17 min/day in 4.7% of patients; predictors were history of atrial fibrillation, higher LVEF, higher body mass index, and activity decrease during lockdown. CONCLUSION Unfavorable changes in physical activity, AHRE burden, and follow-up rate were observed during lockdown, but not in ventricular arrhythmia.
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Affiliation(s)
- Jörn Schmitt
- University Hospital Giessen and Marburg, Giessen, Germany
| | | | | | | | | | | | - Alan Bulava
- Ceske Budejovice Hospital, Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | | | - Robert Hatala
- National Institute of Cardiovascular Diseases, Bratislava, Slovakia
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- University Hospital Giessen and Marburg, Giessen, Germany
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