Reduced Anxiety and Depression in Patients With Advanced Heart Failure After Left Ventricular Assist Device Implantation

摘要

Background: Despite the high prevalence of depression and anxiety in patients with advanced heart failure, the effects of left ventricular assist device (LVAD) implantation on these critically important aspects of mental health are not well understood. Objective: We sought to assess changes in depression and anxiety following LVAD implantation. Methods: The Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) were administered to 54 patients by a clinical psychologist at a mean of 12 days before LVAD implantation and 251 days after implantation. Patient demographics and clinical data were collected concurrently to psychologic testing. Changes in BDI-II, BAI, and clinical markers of heart failure were assessed using paired t-tests. A p < 0.05 was considered significant. Results: The average age of the group was 56.63 years with a mean ejection fraction 20.8%. Before implantation, mean BAI and BDI scores indicated mild depression and anxiety. Following LVAD implantation, average scores for both BDI-II and BAI decreased significantly, indicating minimal depression and anxiety (12.6-8.54, p = 0.001 and 12.06-6.6, p < 0.001, respectively). Mean scores were significantly lowered in 11 and 8 of the 21 subdomains tested by the BAI and BDI, respectively. Significant improvements were noted in post-LVAD B-type natriuretic peptide, serum sodium, and blood urea nitrogen. Conclusion: Depression and anxiety scores improved significantly after LVAD implantation. Factors contributing to changes in depression and anxiety after LVAD could be related to the improvement in acute heart failure sy.mptoms, functional capacity, and quality of life. Prospective studies with larger sample sizes are warranted.