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Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review

Introduction: Depression is a common and severe comorbidity among individuals with heart failure (HF). Up to a third of all HF patients are depressed, and an even higher proportion have symptoms of depression. Aim: In this review, we evaluate the relationship between HF and depression, explain the p...

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Autores principales: Basile, Christian, Parlati, Antonio Luca Maria, Paolillo, Stefania, Marzano, Federica, Nardi, Ermanno, Chirico, Alfonsina, Buonocore, Davide, Colella, Angela, Fontanarosa, Sara, Cotticelli, Ciro, Marchesi, Anna, Rodolico, Daniele, Dellegrottaglie, Santo, Gargiulo, Paola, Prastaro, Maria, Perrone-Filardi, Pasquale, Montisci, Roberta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224073/
https://www.ncbi.nlm.nih.gov/pubmed/37241180
http://dx.doi.org/10.3390/medicina59050948
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author Basile, Christian
Parlati, Antonio Luca Maria
Paolillo, Stefania
Marzano, Federica
Nardi, Ermanno
Chirico, Alfonsina
Buonocore, Davide
Colella, Angela
Fontanarosa, Sara
Cotticelli, Ciro
Marchesi, Anna
Rodolico, Daniele
Dellegrottaglie, Santo
Gargiulo, Paola
Prastaro, Maria
Perrone-Filardi, Pasquale
Montisci, Roberta
author_facet Basile, Christian
Parlati, Antonio Luca Maria
Paolillo, Stefania
Marzano, Federica
Nardi, Ermanno
Chirico, Alfonsina
Buonocore, Davide
Colella, Angela
Fontanarosa, Sara
Cotticelli, Ciro
Marchesi, Anna
Rodolico, Daniele
Dellegrottaglie, Santo
Gargiulo, Paola
Prastaro, Maria
Perrone-Filardi, Pasquale
Montisci, Roberta
author_sort Basile, Christian
collection PubMed
description Introduction: Depression is a common and severe comorbidity among individuals with heart failure (HF). Up to a third of all HF patients are depressed, and an even higher proportion have symptoms of depression. Aim: In this review, we evaluate the relationship between HF and depression, explain the pathophysiology and epidemiology of both diseases and their relationship, and highlight novel diagnostic and therapeutic options for HF patients with depression. Materials and Methods: This narrative review involved keyword searches of PubMed and Web of Science. Review search terms included [“Depression” OR “Depres*” OR “major depr*”] AND [“Heart Failure” OR “HF” OR “HFrEF” OR “HFmrEF” OR “HFpEF” OR “HFimpEF”] in all fields. Studies included in the review met the following criteria: (A) published in a peer-reviewed journal; (B) described the impact of depression on HF and vice versa; and (C) were opinion papers, guidelines, case studies, descriptive studies, randomized control trials, prospective studies, retrospective studies, narrative reviews, and systematic reviews. Results: Depression is an emergent HF risk factor and strongly relates with worse clinical outcomes. HF and depression share multiple pathways, including platelet dis-reactivity, neuroendocrine malfunction, inappropriate inflammation, tachi-arrhythmias, and frailty in the social and community setting. Existing HF guidelines urge evaluation of depression in all HF patients, and numerous screening tools are available. Depression is ultimately diagnosed based on DSM-5 criteria. There are both non-pharmaceutical and pharmaceutical treatments for depression. Regarding depressed symptoms, non-pharmaceutical treatments, such as cognitive-behavioral therapy and physical exercise, have shown therapeutic results, under medical supervision and with an effort level adapted to the patient’s physical resources, together with optimal HF treatment. In randomized clinical studies, selective serotonin reuptake inhibitors, the backbone of antidepressant treatment, did not demonstrate advantage over the placebo in patients with HF. New antidepressant medications are currently being studied and could provide a chance to enhance management, treatment, and control of depression in patients with HF. Conclusions: Despite the substantial link between depression and HF, their combination is underdiagnosed and undertreated. Considering the hopeful yet unclear findings of antidepressant trials, further research is required to identify people who may benefit from antidepressant medication. The goal of future research should be a complete approach to the care of these patients, who are anticipated to become a significant medical burden in the future.
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spelling pubmed-102240732023-05-28 Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review Basile, Christian Parlati, Antonio Luca Maria Paolillo, Stefania Marzano, Federica Nardi, Ermanno Chirico, Alfonsina Buonocore, Davide Colella, Angela Fontanarosa, Sara Cotticelli, Ciro Marchesi, Anna Rodolico, Daniele Dellegrottaglie, Santo Gargiulo, Paola Prastaro, Maria Perrone-Filardi, Pasquale Montisci, Roberta Medicina (Kaunas) Review Introduction: Depression is a common and severe comorbidity among individuals with heart failure (HF). Up to a third of all HF patients are depressed, and an even higher proportion have symptoms of depression. Aim: In this review, we evaluate the relationship between HF and depression, explain the pathophysiology and epidemiology of both diseases and their relationship, and highlight novel diagnostic and therapeutic options for HF patients with depression. Materials and Methods: This narrative review involved keyword searches of PubMed and Web of Science. Review search terms included [“Depression” OR “Depres*” OR “major depr*”] AND [“Heart Failure” OR “HF” OR “HFrEF” OR “HFmrEF” OR “HFpEF” OR “HFimpEF”] in all fields. Studies included in the review met the following criteria: (A) published in a peer-reviewed journal; (B) described the impact of depression on HF and vice versa; and (C) were opinion papers, guidelines, case studies, descriptive studies, randomized control trials, prospective studies, retrospective studies, narrative reviews, and systematic reviews. Results: Depression is an emergent HF risk factor and strongly relates with worse clinical outcomes. HF and depression share multiple pathways, including platelet dis-reactivity, neuroendocrine malfunction, inappropriate inflammation, tachi-arrhythmias, and frailty in the social and community setting. Existing HF guidelines urge evaluation of depression in all HF patients, and numerous screening tools are available. Depression is ultimately diagnosed based on DSM-5 criteria. There are both non-pharmaceutical and pharmaceutical treatments for depression. Regarding depressed symptoms, non-pharmaceutical treatments, such as cognitive-behavioral therapy and physical exercise, have shown therapeutic results, under medical supervision and with an effort level adapted to the patient’s physical resources, together with optimal HF treatment. In randomized clinical studies, selective serotonin reuptake inhibitors, the backbone of antidepressant treatment, did not demonstrate advantage over the placebo in patients with HF. New antidepressant medications are currently being studied and could provide a chance to enhance management, treatment, and control of depression in patients with HF. Conclusions: Despite the substantial link between depression and HF, their combination is underdiagnosed and undertreated. Considering the hopeful yet unclear findings of antidepressant trials, further research is required to identify people who may benefit from antidepressant medication. The goal of future research should be a complete approach to the care of these patients, who are anticipated to become a significant medical burden in the future. MDPI 2023-05-15 /pmc/articles/PMC10224073/ /pubmed/37241180 http://dx.doi.org/10.3390/medicina59050948 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Basile, Christian
Parlati, Antonio Luca Maria
Paolillo, Stefania
Marzano, Federica
Nardi, Ermanno
Chirico, Alfonsina
Buonocore, Davide
Colella, Angela
Fontanarosa, Sara
Cotticelli, Ciro
Marchesi, Anna
Rodolico, Daniele
Dellegrottaglie, Santo
Gargiulo, Paola
Prastaro, Maria
Perrone-Filardi, Pasquale
Montisci, Roberta
Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review
title Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review
title_full Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review
title_fullStr Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review
title_full_unstemmed Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review
title_short Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review
title_sort depression in heart failure with reduced ejection fraction, an undervalued comorbidity: an up-to-date review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224073/
https://www.ncbi.nlm.nih.gov/pubmed/37241180
http://dx.doi.org/10.3390/medicina59050948
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