Potentially Modifiable Correlates of Functional Status in Patients with Chronic Heart Failure
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Potentially Modifiable Correlates of Functional Status in Patients with Chronic Heart Failure. / Lossnitzer, Nicole; Wild, Beate; Schultz, Jobst-Hendrik; Frankenstein, Lutz; Haass, Markus; Rauch, Bernhard; Löwe, Bernd; Katus, Hugo; Herzog, Wolfgang.
In: INT J BEHAV MED, Vol. 21, No. 6, 01.12.2014, p. 956-960.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Potentially Modifiable Correlates of Functional Status in Patients with Chronic Heart Failure
AU - Lossnitzer, Nicole
AU - Wild, Beate
AU - Schultz, Jobst-Hendrik
AU - Frankenstein, Lutz
AU - Haass, Markus
AU - Rauch, Bernhard
AU - Löwe, Bernd
AU - Katus, Hugo
AU - Herzog, Wolfgang
PY - 2014/12/1
Y1 - 2014/12/1
N2 - BACKGROUND: Chronic heart failure (CHF) patients suffer from multiple and agonizing symptoms like shortness of breath and reduced functional status, the latter of which is usually assessed using New York Heart Association (NYHA) functional class.PURPOSE: In order to identify potentially modifiable factors of reduced functional status in patients with CHF, we investigated somatic and psychosocial correlates of NYHA functional class. We subsequently compared the results to correlates of left ventricular ejection fraction (LVEF) as an objective parameter of disease severity.METHODS: The cross-sectional study (n = 314) was part of the German Heart Failure Network. Data were analysed using a logistic regression modelling process.RESULTS: In the final regression model, NYHA functional class was only significantly associated with depression (odds ratio (OR) = 1.18; 95 % confidence interval (CI) = 1.09-1.27) and multimorbidity (OR = 1.17; 95 % CI = 1.04-1.32). LVEF was associated with amino-terminal pro-brain natriuretic peptide (NT-proBNP) (OR = 0.60; 95 % CI = 0.44-0.82), aetiology of CHF (OR = 2.08; 95 % CI = 1.11-3.90), and smoking (OR = 2.21; 95 % CI = 1.25-3.91).CONCLUSIONS: Whereas LVEF was not related to depression, our data revealed a close association between functional status (as assessed by NYHA functional class) and depression in patients with CHF, even after adjusting for cardiac and socio-demographic variables. Different forms of underlying causal mechanisms could be suspected; it appears promising to further investigate this specific interaction. In any event, pending further investigation, our results underscore the need to examine CHF patients with respect to both somatic symptom burden and potential depressive disorders.
AB - BACKGROUND: Chronic heart failure (CHF) patients suffer from multiple and agonizing symptoms like shortness of breath and reduced functional status, the latter of which is usually assessed using New York Heart Association (NYHA) functional class.PURPOSE: In order to identify potentially modifiable factors of reduced functional status in patients with CHF, we investigated somatic and psychosocial correlates of NYHA functional class. We subsequently compared the results to correlates of left ventricular ejection fraction (LVEF) as an objective parameter of disease severity.METHODS: The cross-sectional study (n = 314) was part of the German Heart Failure Network. Data were analysed using a logistic regression modelling process.RESULTS: In the final regression model, NYHA functional class was only significantly associated with depression (odds ratio (OR) = 1.18; 95 % confidence interval (CI) = 1.09-1.27) and multimorbidity (OR = 1.17; 95 % CI = 1.04-1.32). LVEF was associated with amino-terminal pro-brain natriuretic peptide (NT-proBNP) (OR = 0.60; 95 % CI = 0.44-0.82), aetiology of CHF (OR = 2.08; 95 % CI = 1.11-3.90), and smoking (OR = 2.21; 95 % CI = 1.25-3.91).CONCLUSIONS: Whereas LVEF was not related to depression, our data revealed a close association between functional status (as assessed by NYHA functional class) and depression in patients with CHF, even after adjusting for cardiac and socio-demographic variables. Different forms of underlying causal mechanisms could be suspected; it appears promising to further investigate this specific interaction. In any event, pending further investigation, our results underscore the need to examine CHF patients with respect to both somatic symptom burden and potential depressive disorders.
U2 - 10.1007/s12529-014-9385-7
DO - 10.1007/s12529-014-9385-7
M3 - SCORING: Journal article
C2 - 24424794
VL - 21
SP - 956
EP - 960
JO - INT J BEHAV MED
JF - INT J BEHAV MED
SN - 1070-5503
IS - 6
ER -