Heart failure, left ventricular systolic dysfunction, functional status and depression: the crucial interplay

Abstract

Several studies have examined the association between disease severity, functional status, depression and quality of life (QOL) in heart failure (HF). Some suggest that depression has a greater impact on QOL than severity of cardiac dysfunction or functional impairment. Few studies have examined the impact of HF and LV systolic dysfunction (LVSD) on psychosocial health. We analyzed our HF Registry to determine the interplay of all these factors and the impact of HF, LVSD and functional status on the psychological health of patients. Of the 402 patients seen in our HF Clinic between 1/2000 and 11/2003, 77 (19.2%; mean age 67; 69% male) were on oral anti-depressant therapy at presentation for clinically diagnosed depression. Of them, 97.4% had some degree of a support network, including spouse, children, other relatives. Multiple functional, clinical and therapeutic variables were compared at baseline and 1-year after initial presentation. Patients were evaluated at each visit for psychological symptoms and evidence of depression.