Predictors of depressive symptoms in patients with heart failure decompensation

Introduction Acutely decompensated heart failure (HF) may be accompanied by depressive symptoms. Predictors of screening diagnosis of depression (SDD) in decompensated HF are poorly elucidated. Objectives We sought to investigate independent determinants of SDD in patients with HF decompensation. Methods Enrolled were fifty-one patients with a median age of 67 years and left ventricular ejection fraction (LVEF) of <40% hospitalized due to HF decompensation. SDD based on the result of the Beck Depression Inventory (>10 points), PHQ-9 (>12 points) or Hamilton Depression Scale (lack of depression: <7 points; mild [<12 points], moderate [<17 points] or severe [≥18 points] depression). Neurotrophic potential and response to stress were assessed by brain-derived neurotrophic factor (BDNF) and FK506 binding protein 5 (FKBP5), respectively. Results SDD was identified in 26 (51%) patients based on the Beck inventory and in 12 (24%) patients based on PFQ-9. According to the Hamilton scale mild SDD was found in 17 (33.3%), moderate in 9 (17.6%) and severe in 14 (27.5%) of patients. Male patients with HF decompensation had higher result of Beck inventory by 35% (P=0.029), PHQ-9 by 60% (P=0.014) and Hamilton scale by 64% (P=0.003) than female. The result of the Beck Depression Inventory was correlated with plasma levels of FKBP5 (R=0.34, P=0.017) and inversely correlated with BDNF (R=-0.39, P=0.004). In turn, LVEF was correlated with the result of PHQ-9 (r=0.33, P=0.020), Hamilton scale (r=0.33, P=0.18) and with BDNF (r=0.32, P=0.025) while inversely with FKBP5 (r=-0.32, P=0.023). By multivariate analysis the higher result of the Beck inventory was associated with male gender (β=0.26, P=0.048), a higher LVEF (β=0.27, P=0.042) and a lower plasma BDNF (β=-0.46, P<0.001). Conclusions SDD in patients with HF decompensation is independently associated with male gender, better preserved left ventricular systolic function and reduced plasma level of BDNF. Disclosure of Interest None Declared