Depressive symptoms and inflammatory biomarkers in patients with heart failure.
BACKGROUND
Inflammation may be a link between depressive symptoms and outcomes in patients with heart failure. It is not clear whether inflammatory markers are independently related to depressive symptoms in this population.


OBJECTIVE
To determine which inflammatory biomarkers are independently associated with depressive symptoms in heart failure.


RESULTS
We analyzed data from 428 outpatients enrolled in a heart failure registry (32% female, 61 ± 12 years, 48% New York Heart Association Class III/IV). Depressive symptoms were measured with the Beck Depression Inventory-II. Serum C-reactive protein (CRP), cytokines (interleukin 1 receptor antagonist, 2, 4, 6, 8, 10), tumor necrosis alpha, and soluble receptors sTNFR1 and sTNFR2 were measured with enzyme immunoassay. Multiple regressions were used to determine which biomarkers were associated with depressive symptoms controlling for demographics, heart failure severity, and clinical variables. Twenty-seven percent (n = 119) had depressive symptoms. CRP was related to depressive symptoms after controlling for age and gender, but no inflammatory biomarkers were associated with depressive symptoms after controlling for all variables in the model.


CONCLUSIONS
There was no relationship between inflammatory biomarkers and depressive symptoms. Our findings, in combination with prior researchers', suggest there is not a robust relationship between depressive symptoms and individual biomarkers of inflammation in heart failure.
University of Kentucky College of Nursing, Lexington, KY, USA rdekker@uky.edu.
Rebecca L
RL
Dekker
University of Kentucky College of Nursing, Lexington, KY, USA.
Debra K
DK
Moser
University of Kentucky College of Nursing, Lexington, KY, USA.
Elizabeth G
EG
Tovar
University of Kentucky College of Nursing, Lexington, KY, USA.
Misook L
ML
Chung
University of Arkansas for Medical Sciences College of Nursing, Little Rock, AR, USA.
Seongkum
S
Heo
University of North Carolina Chapel Hill School of Nursing, Chapel Hill, NC, USA.
Jia Rong
JR
Wu
Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA.
Sandra B
SB
Dunbar
University of Michigan School of Nursing, Ann Arbor, MI, USA.
Susan J
SJ
Pressler
University of Kentucky College of Nursing, Lexington, KY, USA.
Terry A
TA
Lennie
D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D015984:Causality; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D048069:Tumor Necrosis Factors / Q000097:blood; D014481:United States
D015415:Biomarkers; D053590:Interleukin 1 Receptor Antagonist Protein; D048069:Tumor Necrosis Factors; D002097:C-Reactive Protein
Inflammation; cardiovascular; cytokines; depression; heart failure