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Continuous-flow left ventricular assist devices (CF LVAD) are increasingly used in the therapeutic algorithm for patients with end-stage heart failure (HF). Treated patients show improvements on global health status measures. However, there has been limited investigation regarding the prevalence and course of depression and anxiety in this population.
Depression (PHQ9) and anxiety (GAD7) were assessed prospectively as part of routine clinical care in ambulatory patients with stage D HF supported with a CF LVAD presenting to the outpatient clinic at our institution.
Of 124 CF LVAD patients seen between October 2009 and April 2012, 87 completed the PHQ9 and 70 of these patients also completed the GAD7 (mean age = 55 ± 15; 14% female; 81% white, 61% bridge to transplant). At LVAD implantation, 41% of patients were on psychotropic medication (excluding stimulants and sleep medication), and 40% at last PHQ9/GAD7 administration. We found a significant improvement in mean depression and anxiety following implantation (depression: 11.3 ± 7.2 to 4.7 ± 5.6, p < .0001, anxiety: 7.6 ± 6.0 to 2.7± 2.9, p = 0.004), that remained stable through one year (all pairwise mean comparisons over time were not significant (p > 0.1) (Figure).
Depression and anxiety scores improve after CF LVAD therapy, and remain stable up to one year. The improvement does not appear related to psychotropic medication usage and is likely related to improved health.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure: Therapeutic Insights
Abstract Category: 17. Heart Failure: Therapy
Presentation Number: 1306-279
- 2013 American College of Cardiology Foundation