Conflicts of Interest: The authors have no conflicts of interest to report with this manuscript.
Mood Disorders and Outcome in Patients Receiving Cardiac Resynchronization Therapy
Article first published online: 9 JAN 2012
©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 35, Issue 3, pages 294–301, March 2012
How to Cite
SHALABY, A., BRUMBERG, G., EL-SAED, A. and SABA, S. (2012), Mood Disorders and Outcome in Patients Receiving Cardiac Resynchronization Therapy. Pacing and Clinical Electrophysiology, 35: 294–301. doi: 10.1111/j.1540-8159.2011.03304.x
- Issue published online: 5 MAR 2012
- Article first published online: 9 JAN 2012
- Received May 12, 2011; revised October 11, 2011; accepted November 9, 2011.
- cardiac resynchronization therapy;
- heart failure
Background:Mood disorders (MD) have been demonstrated to influence outcome in cardiac disease in general and specifically in chronic heart failure (HF). Little is known about their possible effect on response to cardiac resynchronization therapy (CRT).
Objective:To evaluate the influence of MD on CRT response.
Methods:We conducted a retrospective chart review of all cardiac CRT-D (CRT defibrillator) recipients (N = 153) at the Veterans Affairs Pittsburgh Healthcare System from beginning of 2004 through end of 2006. All-cause death and HF-related hospitalizations (HFH), individually and combined, were sought through 2009.
Results:During a mean follow-up time of 31.4 ± 14.7 months, there were 48 (31.4%) deaths and 55 (35.9%) HFHs in HF patients having New York Heart Association class of 2.9 ± 0.3, left ventricular ejection fraction (LVEF) of 25.8 ± 9.1%, left ventricular end-diastolic diameter (LVEDD) of 61.6 ± 11.6 mm, and QRS of 152 ± 30.5 ms. A total of 65 (42.5%) patients had MD (depression, anxiety, or posttraumatic stress disorder). Compared to others, patients in the MD group were at a significantly higher risk of HFH alone (47.7% vs 27.3%, P = 0.009) or when combined with death (58.5% vs 39.8%, P = 0.022) but not death alone (35.4% vs 28.4%, P = 0.36). The significant predictive effect of MD on HFH alone and when combined with death shown in univariate analysis was not attenuated after adjustment for age, ejection fraction, etiology of cardiomyopathy, cumulative number of any shocks, smoking, and evidence of postimplantation echocardiographic improvement.
Conclusions:MD in patients with advanced but stable HF receiving CRT-D therapy was a predictor of HFH alone or when combined with death but not mortality alone. (PACE 2011;1–9)