[Can anxiety and depression influence the six-minute walking test performance in post-surgical heart valve patients? A pilot study].
Various functional indicators are utilized to measure outcome in cardiac rehabilitation. Little information exists regarding the role played by psychological variables during the rehabilitative period, after cardiac valve surgery. The present study aims at exploring the relationship existing between different levels of functional capacity measured by six-minute walking test, (6MWT) and emotional aspects such as anxiety and depression.


METHODS
126 post-surgical heart valve patients underwent at the beginning and at the end of the rehabilitative programme: 1) 6MWT; 2) assessment of anxiety and depression (A-D Questionnaire according to the CBA-2.0 Primary Scale).


RESULTS
Cardiac rehabilitation was associated with a general and significant improvement in the 6MWT (273 +/- 98 metres versus 363 +/- 96; p < 0.001) and the functional performance parameters (diastolic blood pressure; p < 0.001 and fatigue p < 0.001). Simultaneously there was a significant improvement of patient-reported quality of life, revealed by the A-D questionnaire in both male and female patients. The Depression Questionnaire score is predictive of functional capacity. It was demonstrated that no matter what the clinical condition of the patient, the depression score influences the patient's performance during the 6MWT, not only regards the distance covered (p = .008), but also fatigue expressed by the Borg RPE index (p = .044).


CONCLUSIONS
Depression, an emotional variable, self-evaluated by the standardized questionnaire can, even if only partially, influence the 6MWT, a functional indicator of exercise tolerance, widely utilized in cardiac rehabilitation.
Bettinardi
Ornella
O
Servizio di Psicologia, Ospedale Privato Accreditato San Giacomo, Ponte dell'Olio, Piacenza. ornella.bettinardi@san-giacomo.it
Bertolotti
Giorgio
G
Baiardi
Paola
P
Calsamiglia
Giuseppe
G
D'Cruz
Sylvia
S
Giacani
Marcello
M
Herodote
Christine
C
Manno
Filippo
F
Molinari
Giuseppe
G
Villa
Paola
P
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000503:physiopathology*; D003863:Depression / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006349:Heart Valve Diseases / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011182:Postoperative Care; D013997:Time Factors