Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jan 19, 2024; 14(1): 53-62
Published online Jan 19, 2024. doi: 10.5498/wjp.v14.i1.53
Assessing myocardial indices and inflammatory factors to determine anxiety and depression severity in patients with chronic heart failure
Li Zhang, Qiang Wang, Hong-Sheng Cui, Yuan-Yuan Luo
Li Zhang, Qiang Wang, Hong-Sheng Cui, Department of Cardiology, Jingzhou Hospital, Yangtze University, Jingzhou 434020, Hubei Province, China
Yuan-Yuan Luo, Department of Intensive Care Unit, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Co-first authors: Li Zhang and Qiang Wang.
Author contributions: Zhang L and Wang Q contributed equally to this work as first co-authors. Zhang L and Wang Q conceived, designed, and refined the study protocol; Cui HS was involved in data collection and analysis; Luo YY guided and supervised the research; and all authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Jingzhou Hospital, Yangtze University Institutional Review Board (2023-053-01).
Informed consent statement: The requirement for informed consent was waived given the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The clinical data used in this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Yuan-Yuan Luo, MM, Associate Chief Physician, Department of Intensive Care Unit, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 16 Airport Road, Guangzhou 510000, Guangdong Province, China.
Received: November 6, 2023
Peer-review started: November 6, 2023
First decision: November 16, 2023
Revised: November 25, 2023
Accepted: December 21, 2023
Article in press: December 21, 2023
Published online: January 19, 2024
Research background

Anxiety and depression (A&D) are common in patients with chronic heart failure (CHF). While extensive research on the general demographic characteristics and A&D data in patients with CHF has been conducted, research on myocardial markers and inflammatory factor levels remains limited. Uncovering the relationship between myocardial markers, inflammatory factor levels, and the degree of A&D in patients with CHF can further supplement and assist in evaluating and classifying A&D severity in patients.

Research motivation

The differential levels of myocardial markers and inflammatory factors depending on A&D severity in patients with CHF could serve as objective evidence to assist clinicians in assessing and classifying the extent of A&D. This could correct for the subjectivity of the general assessment scales, facilitating a more precise distinction between CHF patients with different degrees of A&D, enabling physicians to better manage and rationally allocate medical resources, and providing the potential for personalized treatment.

Research objectives

We classified patients with CHF with varying degrees of A&D based on myocardial markers and inflammatory factor levels and showed that some factors had good discriminative ability, providing the possibility of establishing and assisting in the evaluation of A&D severity in patients with CHF based on biochemical markers.

Research methods

We further explored the inter-group differences in myocardial and inflammatory indicators and showed their ability to predict A&D severity in patients with CHF using regression and the area under the receiver operating characteristic curve (AUROC) analyses.

Research results

Left ventricular ejection fraction, N-terminal pro-brain natriuretic peptide, and interleukin-6 were used in combination to predict and classify 233 patients with CHF in this study into no/mild- and moderate/severe-A&D and achieved good results (AUROC = 0.875, 95% confidence interval: 0.820-0.929).

Research conclusions

Based on our retrospective analysis, we propose that the combination of myocardial and inflammatory factor levels could assist in assessing and classifying the severity of A&D in patients with CHF.

Research perspectives

We plan to further combine other biochemical markers, such as hormone levels, with these classification-effective factors and apply targeted interventions to observe patient outcomes and evaluate changes in A&D severity among patients. This will help to validate our preliminary findings and investigate the potential roles of these biochemical markers in guiding CHF management.