Florou Elizabeth, Sfairopoulos Dimitrios, Plakoutsi Sofia, Bechlioulis Aris, Zekios Konstantinos, Milionis Haralampos, Skapinakis Petros, Korantzopoulos Panagiotis
First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
Second Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
Pacing Clin Electrophysiol. 2025 Aug;48(8):925-931. doi: 10.1111/pace.70002. Epub 2025 Jun 25.
Cardiac resynchronization therapy (CRT) may affect the patients' psychological status differently in various populations. There are limited data regarding depression and anxiety in this setting, while there are no data regarding Greek patients.
We studied heart failure with reduced ejection fraction (HFrEF) patients, without conditions affecting psychological status, undergoing CRT. We used the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder Scale (GAD-7) at baseline and 6- and 12-month postimplantation.
After excluding seven patients who experienced defibrillator shocks, we analyzed 99 patients (median age: 72 years, 77% men). The baseline MLHFQ score was 37 (interquartile range [IQR]: 36); at 6 months, 1 (IQR: 8); and at 12 months, 0.5 (IQR: 10); p < 0.01. The baseline PHQ-9 score was 9 (IQR: 11); at 6 months, 0 (IQR: 2); and at 12 months, 0 (IQR: 2); p < 0.01. The baseline GAD-7 score was 8 (IQR: 16); at 6 months, 0 (IQR: 1.5); and at 12 months, 0 (IQR: 3); p <0.01. At baseline, 44% of patients had clinically significant depression (PHQ-9 score ≥10), and 45% clinically significant anxiety (GAD-7 score ≥10). The baseline PHQ-9 and GAD-7 scores correlated with the MLHFQ score. The logistic regression analysis revealed that clinically substantial depression at baseline (PHQ-9 ≥ 10) had a negative association with chronic kidney disease [OR: 0.55; p < 0.01].
Depression and anxiety markedly improved during the 12-month follow-up period after CRT device implantation in HFrEF patients who did not receive shock therapy.
心脏再同步治疗（CRT）在不同人群中对患者心理状态的影响可能有所不同。关于这方面的抑郁和焦虑的数据有限，而关于希腊患者的数据则尚无。
我们研究了射血分数降低的心力衰竭（HFrEF）患者，这些患者在接受CRT治疗时无影响心理状态的疾病。我们在基线时以及植入后6个月和12个月使用了明尼苏达心力衰竭生活问卷（MLHFQ）、9项患者健康问卷（PHQ-9）和7项广泛性焦虑障碍量表（GAD-7）。
在排除7名经历除颤器电击的患者后，我们分析了99名患者（中位年龄：72岁，77%为男性）。基线时MLHFQ评分为37（四分位间距[IQR]：36）；6个月时为1（IQR：8）；12个月时为0.5（IQR：10）；p<0.01。基线时PHQ-9评分为9（IQR：11）；6个月时为0（IQR：2）；12个月时为0（IQR：2）；p<0.01。基线时GAD-7评分为8（IQR：16）；6个月时为0（IQR：1.5）；12个月时为0（IQR：3）；p<0.01。基线时，44%的患者有临床显著抑郁（PHQ-9评分≥10），45%有临床显著焦虑（GAD-7评分≥10）。基线时PHQ-9和GAD-7评分与MLHFQ评分相关。逻辑回归分析显示，基线时临床显著抑郁（PHQ-9≥10）与慢性肾病呈负相关[比值比：0.55；p<0.01]。
在未接受电击治疗的HFrEF患者中，CRT设备植入后的12个月随访期内，抑郁和焦虑明显改善。
