Evidence map›Paper›PMID 38715254›Full record

Observational studyESC heart failure2024

Depressive symptoms are associated with clinical outcomes in heart failure with reduced ejection fraction.

Andrew Sherwood, James A Blumenthal, Robert J Mentz, Gary G Koch, Joseph G Rogers, Patricia P Chang, Christopher Chien, Kirkwood F Adams, Lisa J Rose-Jones, Brian C Jensen and 3 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Andrew SherwoodDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.ORCID 0000-0001-9067-185X
James A BlumenthalDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Robert J MentzDepartment of Medicine, Duke University Medical Center, Durham, NC, USA.
Gary G KochDepartment of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Joseph G RogersDepartment of Medicine, Duke University Medical Center, Durham, NC, USA.
Patricia P ChangDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Christopher ChienDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Kirkwood F AdamsDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Lisa J Rose-JonesDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Brian C JensenDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Mark DonahueDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Kristy S JohnsonDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Alan L HinderliterDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Funding

STRESS AND HEART FAILURE--PROGNOSIS AND MECHANISMSR01HL061784 · NHLBI · DUKE UNIVERSITY · PI SHERWOOD, ANDREW · 1999 to 2002
$1.4M
National Heart, Lung and Blood Institute of the National Institutes of Health R01 HL61784NHLBI NIH HHS R01 HL061784
6 · The paper itself

Abstract

aimsThe objective of this study was to examine associations between elevated depressive symptoms and increased risk of adverse clinical events patients with heart failure and reduced ejection fraction (HFrEF), as well as the potential contribution of health behaviours. METHODS AND

resultsOne hundred forty-two men and women with HFrEF were enrolled through heart failure (HF) clinics and followed over time. At baseline and 6 months, depressive symptoms were assessed by the Beck Depression Inventory-II (BDI-II) and HFrEF disease activity by B-type natriuretic peptide (BNP). The Self-Care of Heart Failure Index (SCHFI) was used to assess HF self-care behaviours. Proportional hazards regression models assessed the contribution of depressive symptoms and HFrEF disease biomarkers on death or cardiovascular hospitalization. Over a median follow-up period of 4 years, 42 patients (30%) died, and 84 (60%) had cardiovascular hospitalizations. A 10-point higher baseline BDI-II score was associated with a 35% greater risk of death or cardiovascular hospitalization. Higher baseline BDI-II scores were associated with poorer HF self-care maintenance behaviours (R = -0.30, P < 0.001) and fewer daily steps (R = -0.19, P = 0.04), suggesting that elevated depressive symptoms may diminish important health behaviours. Increases in plasma BNP over 6 months were associated with worse outcomes. Changes in BDI-II and plasma BNP over 6 months were positively related (R = 0.25, P = 0.004).

conclusionsThis study confirms that elevated depressive symptoms are associated with an increased likelihood of adverse clinical outcomes in patients with HFrEF. Poor health behaviours may contribute to the adverse association of elevated depressive symptoms with the increased hazard of adverse clinical outcomes.

Indexed as

DepressionHeart FailureStroke VolumeAgedBiomarkersFemaleFollow-Up StudiesHospitalizationHumansMaleMiddle AgedPrognosisProspective StudiesRisk FactorsSurvival RateBiomarkersB‐type natriuretic peptideDepressionEjection fractionHeart failureHFrEF

Identifiers

PMID38715254
PMCPMC11424307

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.