Depressive Symptom Trajectory Predicts 1-Year Health-Related Quality of Life in Patients With Heart Failure

Dekker, Rebecca L.; Lennie, Terry A.; Albert, Nancy M.; Rayens, Mary Kay; Chung, Misook L.; Wu, Jia Rong; Song, Eun Kyeung; Moser, Debra K.

doi:10.1016/j.cardfail.2011.04.016

Cited by 48 publications

(47 citation statements)

References 36 publications

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“…With patient or family assistance, hospital discharge and other medical records were obtained from identified sources of care outside of the study‐site healthcare systems. We have >20 years of experience collecting these data and have successfully obtained hospitalization data on all rural patients in our current and previous studies 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41. All‐cause mortality data (date and cause of death) were collected for 1 year from baseline by a combination of medical record review, electronic clinical record review, interviews with patients’ healthcare providers and family, and public death record review 30, 31, 40, 41, 42, 43…”

Section: Methodsmentioning

confidence: 99%

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Lennie

Andreae

Rayens

et al. 2018

JAHA

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BackgroundDietary micronutrient deficiencies have been shown to predict event‐free survival in other countries but have not been examined in patients with heart failure living in the United States. The purpose of this study was to determine whether number of dietary micronutrient deficiencies in patients with heart failure was associated with shorter event‐free survival, defined as a combined end point of all‐cause hospitalization and death.Methods and ResultsFour‐day food diaries were collected from 246 patients with heart failure (age: 61.5±12 years; 67% male; 73% white; 45% New York Heart Association [NYHA] class III/IV) and analyzed using Nutrition Data Systems for Research. Micronutrient deficiencies were determined according to methods recommended by the Institute of Medicine. Patients were followed for 1 year to collect data on all‐cause hospitalization or death. Patients were divided according to number of dietary micronutrient deficiencies at a cut point of ≥7 for the high deficiency category versus <7 for the no to moderate deficiency category. In the full sample, 29.8% of patients experienced hospitalization or death during the year, including 44.3% in the high‐deficiency group and 25.1% in the no/moderate group. The difference in survival distribution was significant (log rank, P=0.0065). In a Cox regression, micronutrient deficiency category predicted time to event with depression, NYHA classification, comorbidity burden, body mass index, calorie and sodium intake, and prescribed angiotensin‐converting enzyme inhibitors, diuretics, or β‐blockers included as covariates.ConclusionsThis study provides additional convincing evidence that diet quality of patients with heart failure plays an important role in heart failure outcomes.

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Section: Methodsmentioning

confidence: 99%

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Lennie

Andreae

Rayens

et al. 2018

JAHA

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“…From the ENRICHD study (a study in post MI patients), it is known that a large proportion of depressed patients remit spontaneously, without any structured intervention [14]. The same experience has been reported in HF patients [15,16]. In the study of Fulop and colleagues, patients with depressive symptoms at 24 weeks (persistent or recently developed) also used significantly more health care resources compared to those without depressive symptoms [15].…”

Section: Introductionmentioning

confidence: 65%

“…However, in the study by Fulop et al in which HF patients did not receive any specific structured follow-ups, 47% and 71% had remitted from depressive symptoms 4 and 24 weeks post-discharge [15]. High rates of remission was also reported in a recent study of the trajectory of depressive symptoms in HF, in which 50% of the patients experienced improvements by 3 to 6 months [16].…”

Section: Discussionmentioning

confidence: 92%

“…In the study of Fulop and colleagues, patients with depressive symptoms at 24 weeks (persistent or recently developed) also used significantly more health care resources compared to those without depressive symptoms [15]. In the study of Dekker and colleagues, patients with persistent or incident depressive symptoms at 3 or 6 months had the worst health-related quality of life [16]. With the exception of these two studies [15,16] it is today unclear how depressive symptoms in HF patients develop over time and how this trajectory of depressive symptoms is associated with hospital admission and prognosis.…”

Section: Introductionmentioning

confidence: 97%

“…In the study of Dekker and colleagues, patients with persistent or incident depressive symptoms at 3 or 6 months had the worst health-related quality of life [16]. With the exception of these two studies [15,16] it is today unclear how depressive symptoms in HF patients develop over time and how this trajectory of depressive symptoms is associated with hospital admission and prognosis. Such information could help in the interpretation of the effect of depressive symptoms on clinical events and might also guide optimal timing of assessment for depressive symptoms in HF.…”

Section: Introductionmentioning

confidence: 99%

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Time-course of depressive symptoms in patients with heart failure

Johansson

Lesman‐Leegte

Lundgren

et al. 2013

Journal of Psychosomatic Research

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This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Background: It is unclear how depressive symptoms in patients with heart failure develop over time and whether this trajectory of depressive symptoms is associated with hospital admission and prognosis. Aim: To describe the time-course of depressive symptoms and determine the relationship with hospitalisation and mortality. Method: Data was analysed using 611 patients with completed CES-D questionnaires at baseline and at 18 months. Data on hospitalisation was collected 18 months after discharge and data on mortality was collected 18 and 36 months post-discharge. Results: A total of 140 (61%) of the 229 patients with depressive symptoms at discharge had recovered from depressive symptoms after 18 months whereas 71 (18%) of the 382 non-depressed developed depressive symptoms and 89 (39%) of the 229 depressed remained depressed. Patients with recently (i.e. during the last 18 months) developed depressive symptoms showed a significantly higher risk for cardiovascular hospitalisation (HR 1.7, 95% CI 1.1-2.6, P=.016). After 36 months, patients with developed depressive symptoms after discharge were at a higher risk of all-cause mortality (HR 2.0, 95% CI 1.2-3.5, P=.012) and there was a trend towards a higher risk of all-cause mortality in patients with ongoing depressive symptoms (HR 1.7, 95% CI 0.98-3.1, P=.056). Conclusion: A significant proportion of patients with HF, who were reported depressive symptoms at discharge recovered from depressive symptoms during the following 18 months. However, patients who remained having depressive symptoms or patients who developed depressive symptoms had a worse prognosis.

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Palliative care needs in patients hospitalized with heart failure (PCHF) study: rationale and design

et al. 2015

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AimsThe primary aim of this study is to provide data to inform the design of a randomized controlled clinical trial (RCT) of a palliative care (PC) intervention in heart failure (HF). We will identify an appropriate study population with a high prevalence of PC needs defined using quantifiable measures. We will also identify which components a specific and targeted PC intervention in HF should include and attempt to define the most relevant trial outcomes.MethodsAn unselected, prospective, near‐consecutive, cohort of patients admitted to hospital with acute decompensated HF will be enrolled over a 2‐year period. All potential participants will be screened using B‐type natriuretic peptide and echocardiography, and all those enrolled will be extensively characterized in terms of their HF status, comorbidity, and PC needs. Quantitative assessment of PC needs will include evaluation of general and disease‐specific quality of life, mood, symptom burden, caregiver burden, and end of life care. Inpatient assessments will be performed and after discharge outpatient assessments will be carried out every 4 months for up to 2.5 years. Participants will be followed up for a minimum of 1 year for hospital admissions, and place and cause of death. Methods for identifying patients with HF with PC needs will be evaluated, and estimates of healthcare utilisation performed.ConclusionBy assessing the prevalence of these needs, describing how these needs change over time, and evaluating how best PC needs can be identified, we will provide the foundation for designing an RCT of a PC intervention in HF.

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Depressive Symptom Trajectory Predicts 1-Year Health-Related Quality of Life in Patients With Heart Failure

Cited by 48 publications

References 36 publications

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Time-course of depressive symptoms in patients with heart failure

Palliative care needs in patients hospitalized with heart failure (PCHF) study: rationale and design

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