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Leukocyte ß-adrenergic receptor sensitivity and depression severity in patients with heart failure.

ABSTRACT: Clinical outcomes are worse for patients with heart failure (HF) and elevated depression symptoms. Depression-related sympathoimmune dysregulation may be one mechanism leading to poorer HF prognosis. Sympathetically mediated adrenergic activity is known to regulate immune activity via ?-adrenergic receptors (?-ARs). However, studies show conflicting relationships between leukocyte ?-AR sensitivity and depression symptoms. The aim of this study was to determine in patients with HF the relationship of leukocyte ?-AR sensitivity with two diverse measures of depression, self-report questionnaire versus clinical diagnostic interview.Patients with HF (N = 73, mean [standard deviation] age = 56.3 [13.0]) completed the Beck Depression Inventory-1A and a modified Structured Clinical Interview for the DSM-IV. Leukocyte ?-AR sensitivity was determined from isoproterenol-stimulated cyclic adenosine monophosphate levels; plasma norepinephrine and epinephrine were also assessed.Patients with major depression determined by Structured Clinical Interview for the DSM-IV had significantly higher ?-AR sensitivity than did nondepressed patients (F(6,72) = 9.27, p = .003, ? = 0.12). The Beck Depression Inventory-1A revealed a more complex relationship. Minimal, mild, and moderate-to-severe depression symptom groups had significant differences in ?-AR sensitivity (F(7,72) = 7.03, p = .002, ? = 0.18); mild symptoms were associated with reduced ?-AR sensitivity and moderate-to-severe symptoms with higher ?-AR sensitivity compared with patients with minimal depressive symptoms.Clinical depression was associated with elevated ?-AR sensitivity in patients with HF. By deconstructing depression measurements, a greater depth of information may be garnered to potentially reveal subtypes of depression symptoms and their relation to ?-AR sensitivity.

SUBMITTER: Redwine LS

PROVIDER: S-EPMC4744799 | biostudies-literature | 2014 Nov-Dec

REPOSITORIES: biostudies-literature

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Leukocyte ß-adrenergic receptor sensitivity and depression severity in patients with heart failure.

Redwine Laura S LS Hong Suzi S Rutledge Thomas T Wentworth Bailey B Pung Meredith M Ziegler Michael G MG Maisel Alan A Greenberg Barry B Mills Paul J PJ

Psychosomatic medicine 20141101 9

<h4>Objectives</h4>Clinical outcomes are worse for patients with heart failure (HF) and elevated depression symptoms. Depression-related sympathoimmune dysregulation may be one mechanism leading to poorer HF prognosis. Sympathetically mediated adrenergic activity is known to regulate immune activity via β-adrenergic receptors (β-ARs). However, studies show conflicting relationships between leukocyte β-AR sensitivity and depression symptoms. The aim of this study was to determine in patients with ...[more]

PMID: 25373889

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Project description:BACKGROUND: In patients with chronic heart failure, depression is common and associated with poor quality of life, more frequent hospitalizations, and higher mortality. Spiritual well-being is an important, modifiable coping resource in patients with terminal cancer and is associated with less depression, but little is known about the role of spiritual well-being in patients with heart failure. OBJECTIVE: To identify the relationship between spiritual well-being and depression in patients with heart failure. DESIGN: Cross-sectional study. PARTICIPANTS: Sixty patients aged 60 years or older with New York Heart Association class II-IV heart failure. MEASUREMENTS: Spiritual well-being was measured using the total scale and 2 subscales (meaning/peace, faith) of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being scale, depression using the Geriatric Depression Scale-Short Form (GDS-SF). RESULTS: The median age of participants was 75 years. Nineteen participants (32%) had clinically significant depression (GDS-SF > 4). Greater spiritual well-being was strongly inversely correlated with depression (Spearman's correlation -0.55, 95% confidence interval -0.70 to -0.35). In particular, greater meaning/peace was strongly associated with less depression (r = -.60, P < .0001), while faith was only modestly associated (r = -.38, P < .01). In a regression analysis accounting for gender, income, and other risk factors for depression (social support, physical symptoms, and health status), greater spiritual well-being continued to be significantly associated with less depression (P = .05). Between the 2 spiritual well-being subscales, only meaning/peace contributed significantly to this effect (P = .02) and accounted for 7% of the variance in depression. CONCLUSIONS: Among outpatients with heart failure, greater spiritual well-being, particularly meaning/peace, was strongly associated with less depression. Enhancement of patients' sense of spiritual well-being might reduce or prevent depression and thus improve quality of life and other outcomes in this population.

Dataset Information

Leukocyte ß-adrenergic receptor sensitivity and depression severity in patients with heart failure.

Publications

Leukocyte ß-adrenergic receptor sensitivity and depression severity in patients with heart failure.

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