Impact of exercise training and depression on survival in heart failure due to coronary heart disease

Milani, Richard V., Lavie, Carl J., Mehra, Mandeep R. and Ventura, Hector O. (2011) Impact of exercise training and depression on survival in heart failure due to coronary heart disease. American Journal of Cardiology, 107 1: 64-68. doi:10.1016/j.amjcard.2010.08.047


Author Milani, Richard V.
Lavie, Carl J.
Mehra, Mandeep R.
Ventura, Hector O.
Title Impact of exercise training and depression on survival in heart failure due to coronary heart disease
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
Publication date 2011-01
Year available 2010
Sub-type Article (original research)
DOI 10.1016/j.amjcard.2010.08.047
Volume 107
Issue 1
Start page 64
End page 68
Total pages 5
Place of publication United States
Publisher Excerpta Medica, Inc.
Collection year 2011
Language eng
Abstract Depression is prevalent in patients with heart failure (HF) and is associated with increased mortality. In patients with coronary heart disease (CHD) without HF, exercise training (ET) can effectively decrease depressive symptoms resulting in improved survival. We evaluated 189 patients with American College of Cardiology/American Heart Association stage C HF due to CHD (mean left ventricular ejection fraction 35 ± 10%) enrolled in a structured ET program from January 2000 to December 2008, including a group of 151 who completed the program and 38 patients with HF who dropped out of rehabilitation without ET. Depressive symptoms were assessed by standard questionnaire at baseline and after ET, and mortality was determined at a mean follow-up of 4.6 ± 2.6 years. Prevalence of depressive symptoms decreased by 40% after ET, from 22% to 13% (p <0.0001). Patients initially classified as depressed who remained depressed after ET had nearly a fourfold higher mortality than patients whose depression resolved after ET (43% vs 11%, p = 0.005). Depressed patients who completed ET had a 59% lower mortality (44% vs 18%, p <0.05) compared to depressed dropout subjects not undergoing ET. Survival benefits after ET were concentrated to those patients with depression who improved exercise capacity. In conclusion, depressive symptoms are prevalent in patients with HF and are associated with increased mortality. Structured ET is effective in decreasing depressive symptoms, a factor that correlates with improved long-term survival. © 2011 Published by Elsevier Inc.
Keyword Cardiac rehabilitation
Myocardial-infarction
Major depression
Clinical-outcomes
Mortality
Trial
Hospitalization
Prevalence
Recovery
Events
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Sun, 13 Feb 2011, 00:06:14 EST