Abstract
Background Depression is a debilitating comorbidity of heart failure (HF) that needs assessment and management. Along with mind-body exercise to deal with HF with depression, the use of TaiChi and/or Qigong practices (TQPs) has increased. Therefore, this systematic review assesses the effects of TQPs on depression among patients with HF. Methods Randomized controlled trials (RCTs) that examined the effect of TQPs on depression in patients with HF were searched by five databases (PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, CINAHL, and China National Knowledge Infrastructure (CNKI)). With standardized mean difference (SMD) and 95% confidence intervals (95% CI), random-effects meta-analyses of the effect of TQPs on depressive symptoms were performed. Results Of eight included RCTs, seven (481 patients) provided data for the meta-analysis. The pooling revealed that TQPs contribute to depression remission in HF (SMD −0.66; 95% CI −0.98 to −0.33, P < 0.0001; I2 = 64%). Its antidepressive effect was not influenced by intervention duration or exercise setting, but rather by ejection fraction subtype, depressive severity, and depression instruments. The beneficial effects were preserved when the study with the largest effect was removed. Conclusion This study suggests that TQPs might be a good strategy for alleviating depressive symptoms in patients with HF. And rigorous-design RCTs, which focus on the identified research gaps, are needed to further establish the therapeutic effects of TQPs for depression in HF.
Highlights
Depression is a frequent comorbidity in patients with heart failure (HF) [1]
Pooling across the remaining seven Randomized controlled trials (RCTs) (481 patients) provided evidence of a decrease in the depression symptoms with TaiChi and/or Qigong practices (TQPs), but this analysis demonstrated substantial heterogeneity (SMD −0.66, 95% confidence intervals (95% CI) −0.98 to −0.33, P < 0.0001; I2 64%; Figure 2 ; Appendix 2: subgroup analysis)
This is the first systematic review to synthesize RCTs written in both Chinese and English languages that have explored the potential effects of TaiChi and Qigong on depression among patients with HF
Summary
Depression is a frequent comorbidity in patients with heart failure (HF) [1]. Data from meta-analysis have shown that patients with HF have a mean depression prevalence of 21.5%, 2 to 3 times the rate of the general population [2]. Depression often exacerbates symptoms of patients with HF, doubling the risk of mortality and other cardiac events among patients with HF [3] It is a strong predictor of future cardiac events related to HF, similar to traditional cardiovascular risk factors [4]. Erefore, routine screening for and treatment of depression is an urgent need for patients experiencing HF. It is suggested by the European Society of Cardiology (ESC) and American College of Cardiology/American Heart Association (ACC/AHA) HF guidelines [5, 6]. Erefore, this systematic review assesses the effects of TQPs on depression among patients with HF. Rigorous-design RCTs, which focus on the identified research gaps, are needed to further establish the therapeutic effects of TQPs for depression in HF
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