Abstract
OBJECTIVES:Psychiatric depression disorder is common in patients with systolic congestive heart failure (HF), and both conditions share underlying pathophysiological mechanisms. The incidence rate of depression disorder has clearly increased with the increase in HF manifestations in recent decades. Depression disorder is considered an independent predisposing factor for hospitalization, disturbed functional performance, and high rates of morbidity and mortality in HF patients. This randomized controlled study was designed to examine the impacts of low- to moderate-intensity aerobic exercise training on depression status in patients with systolic congestive HF.METHODS:A total of 46 systolic congestive HF patients with depression (40-60 years of age) were randomized to receive twelve weeks of mild- to moderate-intensity aerobic exercise plus standard medical treatment (exercise group) or standard medical treatment without any exercise intervention (control group). Depression status was examined using the validated Patient Health Questionnaire-9 (PHQ9) pre- and post-intervention at the end of the study program.RESULTS:No significant differences were observed between the exercise and control groups in demographic data or clinical characteristics (p>0.05). Both study groups showed a significant reduction in depression status at the end of the 12-week intervention (p<0.05). The comparison between the mean values of the depression scores showed significant differences between the two groups after 6 and 12 weeks of the intervention, indicating a greater reduction in depression scores in the exercise group than in the control group (p<0.05).CONCLUSIONS:Twelve weeks of a low- to moderate-intensity aerobic exercise program was safe and effective for reducing depression severity in patients with systolic congestive HF. Low- to moderate-intensity aerobic training should be recommended for cardiac patients, particularly those with HF-related depression.
Highlights
Some symptoms result from the low level of physical activity, which causes muscle fatigue and dyspnea; other symptoms are caused by a disturbed psychological status, such as that associated with depressive disorder, which leads to negative effects on health-related quality of life (HRQoL) in patients with heart failure (HF) [4,5]
Depression status was significantly lower in the exercise and control groups after 6 and 12 weeks of the intervention with significant differences between the two study groups
After 6 weeks of the intervention, the depression score decreased in the exercise group to 7.74±3.26 with a percentage change of 51.9%, while in the control group, it was reduced to 11.65±3.28 with a percentage change of 26.95%
Summary
Received for publication on November 8, 2018. HF is considered the main reason for critical morbidity and a major factor associated with hospital admission, increasing the mortality rate of the population [1]. The main aim of HF management is to reduce symptoms, increase aerobic capacity, improve health-related quality of life (HRQoL), and overcome the restrictions induced by the disease [2,3]. Some symptoms result from the low level of physical activity, which causes muscle fatigue and dyspnea; other symptoms are caused by a disturbed psychological status, such as that associated with depressive disorder, which leads to negative effects on HRQoL in patients with HF [4,5]
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