Impact of depressive disorders on clinical outcomes in patients with chronic heart failure

Introduction
To date, there are no literature reports of research investigating the relationship between depression and chronic heart failure (CHF) in relation to selected nutritional, cardiac and laboratory parameters.

Aim
To compare CHF parameters in relation to nutritional and laboratory parameters between depressed and non-depressed patients.

Material and methods
We enrolled 94 CHF individuals from Lubelskie Voivodeship to assess depression prevalence and to compare values of cardiac, laboratory and nutritional parameters between depressed and non-depressed patients.

Results
Depression was diagnosed in 66 (70.2%) individuals. We noted significantly lower ejection fraction (EF) (EF%) in the group of depressive patients compared to disease-free individuals (mean EF%: 42 ±12 and 49 ±9; p = 0.030) and worse outcomes in NYHA examination (p < 0.001). Depressed patients had lower body weight (p = 0.023), body mass index (BMI) (p = 0.044), serum albumin concentration (p = 0.015), and hemoglobin concentration (p = 0.042) and an elevated level of C-reactive protein (CRP) (p = 0.025) in comparison to the non-depressed group. The moderate or severely depressed group had a lower level of EF% (p = 0.019) and higher left anterior descending artery (LAD) (p = 0.040) compared with the group suffering from mild depression. We observed greater susceptibility to develop cachexia in patients diagnosed as moderately or severely depressed (p = 0.030). Moreover, in the mentioned group of patients, lower values of body weight (p = 0.037), fat-free mass (FFM) (p = 0.022) and hemoglobin concentration (p = 0.007) were found. Moreover, an inverse correlation between Beck Depression Inventory (BDI) score and EF% (r = –0.371; p = 0.017) was recorded.

Conclusions
Depression in CHF patients is associated with worse cardiac, laboratory and nutritional outcomes. Unfavorable clinical characteristics of CHF patients are related to depression severity.