Abstract
Depression is a common co‐morbidity in heart failure, that adversely affects prognosis. However, depression is highly variable, as it is diagnosed as minimally 5 out of 9 symptoms. NGAL is associated with overall depression in heart failure patients. In this study we investigate the association of NGAL with different depressive symptoms in myocardial infarcted rats.
 Male Wistar rats were subjected to coronary artery ligation (MI) or sham surgery. After 3‐5 weeks, different depressive symptoms were evaluated using behavioral tests. Plasma, CSF and hypothalamic levels of NGAL were measured (Elisa), and NGAL expression in the paraventricular nucleus of the hypothalamus (PVN) was obtained (immunohistochemistry).
 Plasma NGAL levels were increased related to infarct size (r=0.78, p=0.013, N=9), and correlated to CSF and hypothalamic levels, but not to depressive symptoms. NGAL expression in the PVN was increased in MI rats (45±7 vs 26±3 NGAL+ cells per high power field), irrespective of plasma NGAL levels. The number of NGAL positive cells in the PVN was correlated to exploratory behavior in the open field (r=‐0.77, p=0.006); latency to leave the home cage (r=0.51, p=0.026); and sucrose preference (r=0.60, p=0.009), but not to anxiety in the elevated plus maze. 
 Data indicate that while circulating NGAL, representing severity of heart failure, is reflected in CSF and may hence enter the brain, depressive symptoms after myocardial infarction in rats rather are associated with local expression of NGAL in the brain.
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