Abstract 12322: Physical Symptoms and Depression Interact in Predicting Quality-of-Life in Heart Failure

Abstract

Introduction: Quality-of-life (QOL) is an important patient-oriented outcome in heart failure (HF). The interaction effect of physical symptoms and depression in predicting QOL in HF, however, is not well understood. Hypothesis: There is a strong interaction effect between physical symptom and depression in predicting QOL among adults with moderate to advanced HF. Methods: This was a secondary analysis of combined data collected during two prospective cohort studies of symptoms among adults with moderate to advanced HF. Physical symptoms were measured with the Heart Failure Somatic Perception Scale subscale (HFSPS), and depression was measured with the Patient Health Questionnaire-9 (PHQ-9). QOL was measured with the visual analog scale (VAS) of the EQ-5D. Results: The average age of the sample (n=291) was 56.7±13.3 years, and most were male (61.9%). A majority of subjects were classified as New York Heart Association Class III HF (56.4%), and most had non-ischemic etiology (65.2%). Average VAS score on the EQ-5D was 54.27±22.54. Both HFSPS scores (β = -0.58 ± 0.12, p<0.001) and PHQ9 scores (β = -1.77 ± 0.38, p<0.001) were significantly related to VAS scores. There was a significant interaction effect of HFSPS scores and PHQ9 scores in predicting VAS scores (Figure 1; interaction effect: β = 0.02 ± 0.01, p<0.05; model: R2 = 0.28, F(3,265) = 35.18, p<0.001). Conclusions: Physical symptoms and depression have strong independent and interactive effects in predicting QOL in HF, indicating that both should be considered concurrently when managing QOL among adults with HF.