Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Fisioterapia, Diamantina, MG, Brasil.
Universidade Federal de Minas Gerais, Escola de Medicina, Curso de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil.
Rev Soc Bras Med Trop. 2020 Nov 6;53:e20200123. doi: 10.1590/0037-8682-0123-2020. eCollection 2020.
Chagas cardiomyopathy (ChC) is highly stigmatized, and the presence of depressive symptoms may be a common feature. However, its determinants remain unclear. Therefore, the present study aimed to verify the prevalence of depression and the clinical, echocardiographic, functional, and quality of life factors associated with depressive symptoms in patients with ChC and predominantly preserved cardiac function.
Thirty-five patients with ChC (aged 40 to 60 years, 66% men, NYHA I-III) were evaluated by echocardiography, cardiopulmonary exercise testing, 6-minute walk test (6MWT), and Mini-Mental State Examination. Physical activity level was assessed using the Human Activity Profile (HAP) and health-related quality of life was assessed using the Short-Form Health Survey (SF-36). Depressive symptoms were evaluated using the Beck Depression Inventory. A cutoff point greater than 9 was indicative of depression.
Depression was detected in 13 patients (37%). In the univariate analysis, female sex, NYHA functional class, body mass index, HAP score, mental summary of SF-36, peak oxygen uptake, and 6MWT distance were associated with depressive symptoms. The final model showed that only the HAP score (B = -0.533; 95% confidence interval [CI]: -0.804 to -0.262) and SF-36 mental summary (B = -0.269; 95% CI: -0.386 to -0.153) remained as independent predictors of depressive symptoms in patients with ChC.
Depression was prevalent in patients with ChC and predominantly preserved cardiac function. Physical activity and mental health were independent risk factors for depressive symptoms.
恰加斯心肌病（Chagas cardiomyopathy，ChC）高度受歧视，抑郁症状可能是常见特征。但其决定因素尚不清楚。因此，本研究旨在验证抑郁的流行程度以及与 ChC 患者（心功能基本正常，年龄在 40 至 60 岁之间，66%为男性，NYHA I-III 级）相关的抑郁症状的临床、超声心动图、功能和生活质量因素。
通过超声心动图、心肺运动试验、6 分钟步行试验（6MWT）和简易精神状态检查对 35 例 ChC 患者进行评估。使用人体活动概况（HAP）评估身体活动水平，使用健康调查简表 36 项（SF-36）评估健康相关生活质量。使用贝克抑郁量表评估抑郁症状。贝克抑郁量表得分大于 9 表示存在抑郁。
13 例患者（37%）检出抑郁。在单因素分析中，女性、NYHA 心功能分级、体重指数、HAP 评分、SF-36 精神健康总分、峰值摄氧量和 6MWT 距离与抑郁症状相关。最终模型显示，只有 HAP 评分（B=-0.533；95%置信区间[CI]：-0.804 至-0.262）和 SF-36 精神健康总分（B=-0.269；95%CI：-0.386 至-0.153）是 ChC 患者抑郁症状的独立预测因素。
ChC 患者中抑郁较为常见，且心功能基本正常。身体活动和心理健康是抑郁症状的独立危险因素。
