title: Pathophysiological relationships between heart failure and depression and anxiety.
abstract: Depression and anxiety are common comorbid conditions in patients with heart failure. Patients with heart failure and depression have increased mortality. The association of anxiety with increased mortality in patients with heart failure is not established. The purpose of this article is to illustrate the similarities of the underlying pathophysiology of heart failure, depression, and anxiety by using the Biopsychosocial Holistic Model of Cardiovascular Health. Depression and anxiety affect biological processes of cardiovascular function in patients with heart failure by altering neurohormonal function via activation of the hypothalamic-pituitary-adrenal axis, autonomic dysregulation, and activation of cytokine cascades and platelets. Patients with heart failure and depression or anxiety may exhibit a continued cycle of heart failure progression, increased depression, and increased anxiety. Understanding the underlying pathophysiological relationships in patients with heart failure who experience comorbid depression and/or anxiety is critical in order to implement appropriate treatments, educate patients and caregivers, and educate other health professionals.
authors.forename: Deborah W
authors.initials: DW
authors.lastname: Chapa
authors.forename: Bimbola
authors.initials: B
authors.lastname: Akintade
authors.forename: Heesook
authors.initials: H
authors.lastname: Son
authors.forename: Patricia
authors.initials: P
authors.lastname: Woltz
authors.forename: Dennis
authors.initials: D
authors.lastname: Hunt
authors.forename: Erika
authors.initials: E
authors.lastname: Friedmann
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Hartung
authors.forename: Sue Ann
authors.initials: SA
authors.lastname: Thomas
mesh_terms: D001007:Anxiety / Q000209:etiology*; D016207:Cytokines / Q000378:metabolism; D016757:Death, Sudden, Cardiac; D003863:Depression / Q000209:etiology*; D015444:Exercise / Q000502:physiology; D005190:Family; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008960:Models, Psychological; D018377:Neurotransmitter Agents / Q000502:physiology; D010353:Patient Education as Topic; D015539:Platelet Activation / Q000502:physiology; D012084:Renin-Angiotensin System / Q000502:physiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology
chemical_list: D016207:Cytokines; D018377:Neurotransmitter Agents; D017367:Selective Serotonin Reuptake Inhibitors