title: Association between psychological measures and brain natriuretic peptide in heart failure patients.
abstract: OBJECTIVE
  Brain natriuretic peptide (BNP) is a promising marker for heart failure diagnosis and prognosis. Although psychological factors also influence heart failure (HF) prognosis, this might be attributed to confounding by BNP. Our aim was to examine the association between multiple psychological markers using a prospective study design with repeated N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements.
  
  
  METHODS
  The sample comprised 94 outpatients with systolic HF (80% men; mean age =62.2 ± 9.3). The psychological markers (i.e., anxiety, depression, and Type D personality), assessed with the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory (BDI), and the Type D Scale (DS14) were assessed only at baseline. Plasma NT-proBNP levels were measured at baseline and at 9 months.
  
  
  RESULTS
  The prevalence of anxiety, depression, and Type D personality at baseline was 23.4% (HADS-A), 17.0% (HADS-D), 46.6% (BDI), and 21.3% (DS14), respectively. At baseline, none of the psychological risk markers were associated with NT-proBNP levels (all p >.05). In the subset of patients with scores on psychological risk markers both at baseline and at 9 months, there were no association between anxiety (p =0.44), depression (HADS-D: p =0.90; BDI: p =0.85), and Type D (p =0.63) with NT-proBNP levels using ANOVA for repeated measures.
  
  
  CONCLUSIONS
  Our findings indicate that measures frequently used in HF to assess psychological risk markers are unconfounded by NT-proBNP. Futher studies are warranted to replicate these findings and examine whether psychological risk markers are independent predictors of prognosis in HF or an artifact that may be attributed to other biological or behavioral mechanisms.
authors.affiliation: CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical Psychology, Tilburg University, the Netherlands.
authors.forename: Corline
authors.initials: C
authors.lastname: Brouwers
authors.forename: Helle
authors.initials: H
authors.lastname: Spindler
authors.forename: Mogens Lytken
authors.initials: ML
authors.lastname: Larsen
authors.forename: Hans
authors.initials: H
authors.lastname: Eiskær
authors.forename: Lars
authors.initials: L
authors.lastname: Videbæk
authors.forename: Mette Storgaard
authors.initials: MS
authors.lastname: Pedersen
authors.forename: Bitten
authors.initials: B
authors.lastname: Aagard
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015415:Biomarkers / Q000097:blood; D015986:Confounding Factors, Epidemiologic; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010551:Personality; D010552:Personality Assessment; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain