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Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus

BACKGROUND: The presence of concomitant Type II diabetic mellitus (T2DM) and depressive symptoms adversely affects individuals with symptomatic heart failure (HF). HYPOTHESIS: In presymptomatic stage B HF, this study hypothesized the presence of greater inflammation and depressive symptoms in T2DM a...

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Autores principales: Mills, Paul J., Taub, Pam R., Lunde, Ottar, Pung, Meredith A., Wilson, Kathleen, Pruitt, Christopher, Rutledge, Thomas, Maisel, Alan, Greenberg, Barry H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Periodicals, Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553353/
https://www.ncbi.nlm.nih.gov/pubmed/31017303
http://dx.doi.org/10.1002/clc.23187
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author Mills, Paul J.
Taub, Pam R.
Lunde, Ottar
Pung, Meredith A.
Wilson, Kathleen
Pruitt, Christopher
Rutledge, Thomas
Maisel, Alan
Greenberg, Barry H.
author_facet Mills, Paul J.
Taub, Pam R.
Lunde, Ottar
Pung, Meredith A.
Wilson, Kathleen
Pruitt, Christopher
Rutledge, Thomas
Maisel, Alan
Greenberg, Barry H.
author_sort Mills, Paul J.
collection PubMed
description BACKGROUND: The presence of concomitant Type II diabetic mellitus (T2DM) and depressive symptoms adversely affects individuals with symptomatic heart failure (HF). HYPOTHESIS: In presymptomatic stage B HF, this study hypothesized the presence of greater inflammation and depressive symptoms in T2DM as compared to non‐T2DM Stage B patients. METHODS: This cross‐sectional study examined clinical parameters, inflammatory biomarkers, and depressive symptoms in 349 T2DM and non‐T2DM men with asymptomatic stage B HF (mean age 66.4 years ±10.1; range 30‐91). RESULTS: Fewer diabetic HF patients had left ventricular (LV) systolic dysfunction (P < .05) although more had LV diastolic dysfunction (P < .001). A higher percentage of T2DM HF patients were taking ACE‐inhibitors, beta‐blockers, calcium channel blockers, statins, and diuretics (P values < .05). T2DM HF patients had higher circulating levels of interleukin‐6 (IL‐6) (P < .01), tumor necrosis factor‐alpha (P < .01), and soluble ST2 (sST2) (P < .01) and reported more somatic/affective depressive symptoms (Beck Depression Inventory II) (P < .05) but not cognitive/affective depressive symptoms (P = .20). Among all patients, in a multiple regression analysis predicting presence of somatic/affective depressive symptoms, sST2 (P = .026), IL‐6 (P = .010), B‐type natriuretic peptide (P = .016), and sleep (Pittsburgh Sleep Quality Index [P < .001]) were significant predictors (overall model F = 15.39, P < .001, adjusted R (2) = .207). CONCLUSIONS: Somatic/affective but not cognitive/affective depressive symptoms are elevated in asymptomatic HF patients with T2DM patients. Linkages with elevated inflammatory and cardiac relevant biomarkers suggest shared pathophysiological mechanisms among T2DM HF patients with somatic depression, and these conditions are responsive to routine interventions, including behavioral. Copyright © 2019 John Wiley & Sons, Ltd.
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spelling pubmed-65533532019-08-28 Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus Mills, Paul J. Taub, Pam R. Lunde, Ottar Pung, Meredith A. Wilson, Kathleen Pruitt, Christopher Rutledge, Thomas Maisel, Alan Greenberg, Barry H. Clin Cardiol Clinical Investigations BACKGROUND: The presence of concomitant Type II diabetic mellitus (T2DM) and depressive symptoms adversely affects individuals with symptomatic heart failure (HF). HYPOTHESIS: In presymptomatic stage B HF, this study hypothesized the presence of greater inflammation and depressive symptoms in T2DM as compared to non‐T2DM Stage B patients. METHODS: This cross‐sectional study examined clinical parameters, inflammatory biomarkers, and depressive symptoms in 349 T2DM and non‐T2DM men with asymptomatic stage B HF (mean age 66.4 years ±10.1; range 30‐91). RESULTS: Fewer diabetic HF patients had left ventricular (LV) systolic dysfunction (P < .05) although more had LV diastolic dysfunction (P < .001). A higher percentage of T2DM HF patients were taking ACE‐inhibitors, beta‐blockers, calcium channel blockers, statins, and diuretics (P values < .05). T2DM HF patients had higher circulating levels of interleukin‐6 (IL‐6) (P < .01), tumor necrosis factor‐alpha (P < .01), and soluble ST2 (sST2) (P < .01) and reported more somatic/affective depressive symptoms (Beck Depression Inventory II) (P < .05) but not cognitive/affective depressive symptoms (P = .20). Among all patients, in a multiple regression analysis predicting presence of somatic/affective depressive symptoms, sST2 (P = .026), IL‐6 (P = .010), B‐type natriuretic peptide (P = .016), and sleep (Pittsburgh Sleep Quality Index [P < .001]) were significant predictors (overall model F = 15.39, P < .001, adjusted R (2) = .207). CONCLUSIONS: Somatic/affective but not cognitive/affective depressive symptoms are elevated in asymptomatic HF patients with T2DM patients. Linkages with elevated inflammatory and cardiac relevant biomarkers suggest shared pathophysiological mechanisms among T2DM HF patients with somatic depression, and these conditions are responsive to routine interventions, including behavioral. Copyright © 2019 John Wiley & Sons, Ltd. Wiley Periodicals, Inc. 2019-04-29 /pmc/articles/PMC6553353/ /pubmed/31017303 http://dx.doi.org/10.1002/clc.23187 Text en © 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigations
Mills, Paul J.
Taub, Pam R.
Lunde, Ottar
Pung, Meredith A.
Wilson, Kathleen
Pruitt, Christopher
Rutledge, Thomas
Maisel, Alan
Greenberg, Barry H.
Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus
title Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus
title_full Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus
title_fullStr Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus
title_full_unstemmed Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus
title_short Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus
title_sort depressive symptoms in asymptomatic stage b heart failure with type ii diabetic mellitus
topic Clinical Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553353/
https://www.ncbi.nlm.nih.gov/pubmed/31017303
http://dx.doi.org/10.1002/clc.23187
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