Depression and Anxiety in Patients Who Received a CRT Device and Did Not Have Shock Therapy During a 12-Month Follow-Up.

Abstract

Introduction: Cardiac resynchronization therapy (CRT) may affect the patients' psychological status differently in various populations. There are limited data regarding depression and anxiety in this setting, while there are no data regarding Greek patients.

Methods: We studied heart failure with reduced ejection fraction (HFrEF) patients, without conditions affecting psychological status, undergoing CRT. We used the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder Scale (GAD-7) at baseline and 6- and 12-month postimplantation.

Results: After excluding seven patients who experienced defibrillator shocks, we analyzed 99 patients (median age: 72 years, 77% men). The baseline MLHFQ score was 37 (interquartile range [IQR]: 36); at 6 months, 1 (IQR: 8); and at 12 months, 0.5 (IQR: 10); p < 0.01. The baseline PHQ-9 score was 9 (IQR: 11); at 6 months, 0 (IQR: 2); and at 12 months, 0 (IQR: 2); p < 0.01. The baseline GAD-7 score was 8 (IQR: 16); at 6 months, 0 (IQR: 1.5); and at 12 months, 0 (IQR: 3); p <0.01. At baseline, 44% of patients had clinically significant depression (PHQ-9 score ≥10), and 45% clinically significant anxiety (GAD-7 score ≥10). The baseline PHQ-9 and GAD-7 scores correlated with the MLHFQ score. The logistic regression analysis revealed that clinically substantial depression at baseline (PHQ-9 ≥ 10) had a negative association with chronic kidney disease [OR: 0.55; p < 0.01].

Conclusions: Depression and anxiety markedly improved during the 12-month follow-up period after CRT device implantation in HFrEF patients who did not receive shock therapy.