title: Prognostic implication of earthquake-related loss and depressive symptoms in patients with heart failure following the 2008 earthquake in Sichuan.
abstract: BACKGROUND
  Earthquake exposure is associated with adverse consequences for cardiovascular disease. However, in the context of depressive symptoms, the prognostic significance of heart failure (HF) related to earthquake-related loss has not been characterized before.
  
  
  OBJECTIVE
  To determine the prognostic impact of earthquake-related loss on event-free survival in patients with HF, with depression as a modifying factor.
  
  
  METHODS
  Depressive symptoms were assessed by using the Zung Self-Rating Depression Scale in 404 HF patients who were followed up for 2 years after the earthquake to collect data on mortality and readmission. The Kaplan-Meier method was used to compare event-free survival between patients with and without earthquake-related loss. Cox proportional hazard regression modeling was used to examine the predicted outcomes for baseline variables.
  
  
  RESULTS
  The proportion of patients with moderate/severe depressive symptoms among the HF patients with earthquake-related loss is much higher than their counterparts (27.038% vs 17.84%, P = 0.039). Heart failure patients without loss experienced longer event-free survival than patients with loss (P = 0.002), especially among patients without depressive symptoms (P = 0.003). Meanwhile, in a Cox proportional hazard regression model, the event-free survival was associated with earthquake-related loss, left ventricular ejection fraction, depressive symptoms, and chronic obstructive pulmonary disease or asthma.
  
  
  CONCLUSIONS
  Heart failure patients without earthquake-related loss experienced longer event-free survival than did HF patients with severe loss. Earthquake-related loss was a predictor of poor outcomes in HF patients, particularly in patients without depression.
authors.affiliation: Department of Cardiology, People's Hospital of Deyang City, Deyang, China.
authors.forename: Kaisen
authors.initials: K
authors.lastname: Huang
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Deng
authors.forename: Dingxiu
authors.initials: D
authors.lastname: He
authors.forename: Dejia
authors.initials: D
authors.lastname: Huang
authors.forename: Qi
authors.initials: Q
authors.lastname: Wu
authors.forename: Shuyin
authors.initials: S
authors.lastname: Wen
authors.forename: Yougen
authors.initials: Y
authors.lastname: Zhou
authors.forename: Fangming
authors.initials: F
authors.lastname: Zhou
authors.forename: Yingde
authors.initials: Y
authors.lastname: Kang
authors.forename: Mao
authors.initials: M
authors.lastname: Chen
mesh_terms: D002681:China / Q000453:epidemiology; D003863:Depression / Q000150:complications / Q000401:mortality*; D018572:Disease-Free Survival; D055866:Earthquakes / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality / Q000523:psychology*; D006801:Humans; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011594:Psychometrics; D016019:Survival Analysis
references.citation: Arteriosclerosis. 1986 Sep-Oct;6(5):491-4
references.pmid: 3767693
references.citation: J Am Geriatr Soc. 1997 May;45(5):610-3
references.pmid: 9158584
references.citation: Int J Epidemiol. 1986 Sep;15(3):326-30
references.pmid: 3771068
references.citation: J Am Coll Cardiol. 1994 Mar 1;23(3):809-13
references.pmid: 8113568
references.citation: Am J Epidemiol. 1998 Dec 1;148(11):1077-84
references.pmid: 9850130
references.citation: Am Heart J. 2006 Nov;152(5):940.e1-8
references.pmid: 17070164
references.citation: Lancet. 1983 Feb 26;1(8322):441-4
references.pmid: 6131167
references.citation: Heart. 2009 Dec;95(24):2009-13
references.pmid: 19541690
references.citation: J Am Coll Cardiol. 2006 Oct 17;48(8):1527-37
references.pmid: 17045884
references.citation: Psychosom Med. 2003 Jan-Feb;65(1):119-28
references.pmid: 12554823
references.citation: Hellenic J Cardiol. 2009 Sep-Oct;50(5):410-7
references.pmid: 19767283
references.citation: Arch Intern Med. 2001 Aug 13-27;161(15):1849-56
references.pmid: 11493126
references.citation: Circ J. 2009 Jul;73(7):1195-6
references.pmid: 19556698
references.citation: J Am Coll Cardiol. 1997 Nov 1;30(5):1174-80
references.pmid: 9350911
references.citation: J Cardiopulm Rehabil Prev. 2009 May-Jun;29(3):171-8
references.pmid: 19471136
references.citation: Cleve Clin J Med. 2010 Jul;77 Suppl 3:S7-S11
references.pmid: 20622081