Background: Psychological depression has been linked to heart failure, both an antecedent to and as a risk factor for poor outcomes among patients with existing heart failure. Elevated levels of proinflammatory cytoki...Background: Psychological depression has been linked to heart failure, both an antecedent to and as a risk factor for poor outcomes among patients with existing heart failure. Elevated levels of proinflammatory cytokines have been proposed as a possible physiological link between the 2 conditions. The objective of this study was to examine the proinflammatory cytokines interleukin(IL)-6, IL-1β, and tumor necrosis factor alpha(TNFα) in heart failure patients with and without elevated symptoms of depression. Methods: Thirty-two heart failure patients were recruited from an outpatient heart failure clinic. Depressive symptoms were measured with the Beck Depression Inventory(BDI), and a patient was classified as having elevated symptoms of depression if he/she scored ≥10. The cognitive affective subscale score of the BDI, which measures depressed mood independent of physical symptoms, was also examined. Results: In the multiple linear regression models controlling for age, sex, smoking, and antidepressant medication use, there was no relation between BDI score and IL-6(P=.7612) or IL-1β(P=.8261). However, there was a statistically significant positive relation between BDI score and TNFα(P=.0374). There was also a significant relation between an elevated cognitive-affective score and TNFα(P=.0322) but no association with IL-6(P=.8593) or IL-1β(P=.3737). Conclusions: The association between TNFαand the cognitive-affective subscale, which eliminates the physical signs and symptoms that are shared by depression and heart failure, demonstrates a depression-specific activation of proinflammatory cytokines that may promote disease progression and mortality in patients with heart failure.展开更多
文摘Background: Psychological depression has been linked to heart failure, both an antecedent to and as a risk factor for poor outcomes among patients with existing heart failure. Elevated levels of proinflammatory cytokines have been proposed as a possible physiological link between the 2 conditions. The objective of this study was to examine the proinflammatory cytokines interleukin(IL)-6, IL-1β, and tumor necrosis factor alpha(TNFα) in heart failure patients with and without elevated symptoms of depression. Methods: Thirty-two heart failure patients were recruited from an outpatient heart failure clinic. Depressive symptoms were measured with the Beck Depression Inventory(BDI), and a patient was classified as having elevated symptoms of depression if he/she scored ≥10. The cognitive affective subscale score of the BDI, which measures depressed mood independent of physical symptoms, was also examined. Results: In the multiple linear regression models controlling for age, sex, smoking, and antidepressant medication use, there was no relation between BDI score and IL-6(P=.7612) or IL-1β(P=.8261). However, there was a statistically significant positive relation between BDI score and TNFα(P=.0374). There was also a significant relation between an elevated cognitive-affective score and TNFα(P=.0322) but no association with IL-6(P=.8593) or IL-1β(P=.3737). Conclusions: The association between TNFαand the cognitive-affective subscale, which eliminates the physical signs and symptoms that are shared by depression and heart failure, demonstrates a depression-specific activation of proinflammatory cytokines that may promote disease progression and mortality in patients with heart failure.
