Symptoms, Depression, and Quality of Life in Patients With Heart Failure

David B. Bekelman, Edward P. Havranek, Diane M Becker, Jean S. Kutner, Pamela N. Peterson, Ilan S Wittstein, Sheldon Gottlieb, Traci E. Yamashita, Diane L. Fairclough, Sydney E Dy

Research output: Contribution to journalArticle

Abstract

Background: Little is known about symptoms and their burden in outpatients with chronic heart failure. Diverse symptoms may be associated with poor heart failure-related quality of life, and depression may be related to increased symptoms. Methods and Results: The number of symptoms and symptom distress (physical symptoms on the Memorial Symptom Assessment Scale-Short Form), depression (Geriatric Depression Scale-Short Form), and heart failure-related quality of life (Kansas City Cardiomyopathy Questionnaire) were measured cross-sectionally in 60 patients with heart failure from two outpatient cardiology clinics. Patients experienced a mean of nine symptoms in the previous week. More than half reported shortness of breath, lack of energy, pain, feeling drowsy, or dry mouth. In unadjusted analyses, more severe depression was associated with a greater number of symptoms (r = 0.51, P <.0001) and greater overall symptom distress (r = 0.58, P <.0001). For each additional depression symptom, the number of symptoms reported increased by 0.6 after adjustment for age, race, and N-terminal pro-brain natriuretic peptide (P = .01). The number of symptoms accounted for 32% of the variance in quality of life (P <.0001). Conclusions: Patients with heart failure report a large number of distressing symptoms. Depression in patients with heart failure is associated with a greater number of symptoms, which in turn is associated with a decrease in heart failure-related quality of life. Treatment of depression and the diverse symptoms reported by patients with heart failure might significantly improve quality of life.

Original languageEnglish (US)
Pages (from-to)643-648
Number of pages6
JournalJournal of Cardiac Failure
Volume13
Issue number8
DOIs
StatePublished - Oct 2007

Fingerprint

Heart Failure
Quality of Life
Depression
Symptom Assessment
Brain Natriuretic Peptide
Ambulatory Care Facilities
Cardiology
Cardiomyopathies
Geriatrics
Dyspnea
Mouth
Emotions
Outpatients
Pain

Keywords

  • depression
  • heart failure
  • palliative care
  • Quality of life
  • symptoms

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Symptoms, Depression, and Quality of Life in Patients With Heart Failure. / Bekelman, David B.; Havranek, Edward P.; Becker, Diane M; Kutner, Jean S.; Peterson, Pamela N.; Wittstein, Ilan S; Gottlieb, Sheldon; Yamashita, Traci E.; Fairclough, Diane L.; Dy, Sydney E.

In: Journal of Cardiac Failure, Vol. 13, No. 8, 10.2007, p. 643-648.

Research output: Contribution to journalArticle

Bekelman, David B. ; Havranek, Edward P. ; Becker, Diane M ; Kutner, Jean S. ; Peterson, Pamela N. ; Wittstein, Ilan S ; Gottlieb, Sheldon ; Yamashita, Traci E. ; Fairclough, Diane L. ; Dy, Sydney E. / Symptoms, Depression, and Quality of Life in Patients With Heart Failure. In: Journal of Cardiac Failure. 2007 ; Vol. 13, No. 8. pp. 643-648.
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AU - Havranek, Edward P.

AU - Becker, Diane M

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AU - Peterson, Pamela N.

AU - Wittstein, Ilan S

AU - Gottlieb, Sheldon

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N2 - Background: Little is known about symptoms and their burden in outpatients with chronic heart failure. Diverse symptoms may be associated with poor heart failure-related quality of life, and depression may be related to increased symptoms. Methods and Results: The number of symptoms and symptom distress (physical symptoms on the Memorial Symptom Assessment Scale-Short Form), depression (Geriatric Depression Scale-Short Form), and heart failure-related quality of life (Kansas City Cardiomyopathy Questionnaire) were measured cross-sectionally in 60 patients with heart failure from two outpatient cardiology clinics. Patients experienced a mean of nine symptoms in the previous week. More than half reported shortness of breath, lack of energy, pain, feeling drowsy, or dry mouth. In unadjusted analyses, more severe depression was associated with a greater number of symptoms (r = 0.51, P <.0001) and greater overall symptom distress (r = 0.58, P <.0001). For each additional depression symptom, the number of symptoms reported increased by 0.6 after adjustment for age, race, and N-terminal pro-brain natriuretic peptide (P = .01). The number of symptoms accounted for 32% of the variance in quality of life (P <.0001). Conclusions: Patients with heart failure report a large number of distressing symptoms. Depression in patients with heart failure is associated with a greater number of symptoms, which in turn is associated with a decrease in heart failure-related quality of life. Treatment of depression and the diverse symptoms reported by patients with heart failure might significantly improve quality of life.

AB - Background: Little is known about symptoms and their burden in outpatients with chronic heart failure. Diverse symptoms may be associated with poor heart failure-related quality of life, and depression may be related to increased symptoms. Methods and Results: The number of symptoms and symptom distress (physical symptoms on the Memorial Symptom Assessment Scale-Short Form), depression (Geriatric Depression Scale-Short Form), and heart failure-related quality of life (Kansas City Cardiomyopathy Questionnaire) were measured cross-sectionally in 60 patients with heart failure from two outpatient cardiology clinics. Patients experienced a mean of nine symptoms in the previous week. More than half reported shortness of breath, lack of energy, pain, feeling drowsy, or dry mouth. In unadjusted analyses, more severe depression was associated with a greater number of symptoms (r = 0.51, P <.0001) and greater overall symptom distress (r = 0.58, P <.0001). For each additional depression symptom, the number of symptoms reported increased by 0.6 after adjustment for age, race, and N-terminal pro-brain natriuretic peptide (P = .01). The number of symptoms accounted for 32% of the variance in quality of life (P <.0001). Conclusions: Patients with heart failure report a large number of distressing symptoms. Depression in patients with heart failure is associated with a greater number of symptoms, which in turn is associated with a decrease in heart failure-related quality of life. Treatment of depression and the diverse symptoms reported by patients with heart failure might significantly improve quality of life.

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