Decreased Brain-Derived Neurotrophic Factor, Increased FK506 Binding Protein 5 and Female Sex Are Associated with Multiscale-Assessed Depressive Symptoms During Heart Failure Decompensation: A Polish Prospective Cohort Study

Background/Objectives: Acute decompensated heart failure (ADHF) may be accompanied by depressive symptoms. Risk factors for a screening diagnosis of depression (SDD) in ADHF are poorly understood. Methods: We enrolled 51 patients with a median age 67 years hospitalized due to ADHF. SDD was determined by the Beck Depression Inventory (BDI) with >12 points or by the Patient Health Questionnaire-9 (PHQ-9) with >11 points. Severe depressive symptoms were diagnosed based on a Hamilton Depression Rating Scale (HDRS) score of >17 points. Baseline neurotrophic potential and stress response were assessed by plasma brain-derived neurotrophic factor (BDNF) and FK506 binding protein 5 (FKBP5), respectively. Results: SDD was identified in 20 (39.2%) patients based on the BDI, in 13 (25.5%) based on the PHQ-9, while severe depressive symptoms according to the HDRS were found in 15 (29.4%) patients. Women had higher BDI (p = 0.044), PHQ-9 (p = 0.022) and HDRS (p = 0.006) scores than men. The BDI score correlated with plasma FKBP5 (r = 0.317, p = 0.025) and inversely with BDNF (r = −0.380, p = 0.006). In multivariable analysis, a higher BDI score was associated with female sex (β = 0.294, p = 0.033) and lower plasma BDNF (β = −0.330, p = 0.015), while a higher HDRS score was associated with female sex (β = 0.312, p = 0.010) and higher plasma FKBP5 (β = 0.388, p = 0.007). Conclusions: In a multi-scale assessment, SDD or severe depressive symptoms were identified in 25–40% of ADHF patients. A higher BDI score was independently associated with lower BDNF, whereas a higher HDRS score was associated with female sex and higher FKBP5.