title: Association of depression symptoms with quality of life and chronic artery vasculopathy: a cross-sectional study in heart transplant patients.
abstract: OBJECTIVE
  Depression represents a relevant co-morbidity in patients with chronic heart disease and may diminish the overall success for long-term survival after heart transplantation (HTx). This study aimed to assess the prevalence of depression symptoms in long-term HTx survivors, and to compare depressive patients to those without depression with respect to chronic artery vasculopathy (CAV).
  
  
  METHODS
  A sample of 203 HTx patients, median 11.5 (IQR 7-17) years after transplant, provided detailed data of depression symptoms, and other psychosocial symptoms including anxiety, family support, professional re-integration, and health-related quality of life (HRQoL). Data were analyzed for an association with CAV.
  
  
  RESULTS
  Overall, 14.8% patients (95% CI: 10.2-20.4) showed relevant depression symptoms. No significant differences were seen between non-depressed vs. depressed patients with respect to demographics, clinical variables, and cardiovascular risk factors. Anxiety was prevalent in 9.0% (95% CI: 5.4-13.9) of the sample. Depression symptoms showed impaired HRQoL in the SF-36 physical (P=.012) and psychosocial (P=.0001) components. CAV was prevalent in 34.0% (95% CI: 27.5-41.0), and depression symptoms and CAV were not significantly associated. CAV-patients did not report their physical HRQoL being lower relative to those without CAV (P=.40). Multivariate analysis revealed overweight BMI (OR=2.20; P=.04), longer time since transplant (OR=1.10; P=.001), and older age (OR=1.04; P=.01) being associated with CAV.
  
  
  CONCLUSIONS
  Depression symptoms are prevalent in long-term survivors after HTx, and psychological impairments decrease patients' perceptions of HRQoL. More research seems necessary to identify the inter-relationship between depression symptoms and CAV, in order to develop targeted interventions to overcome this problem.
authors: Division of Cardiac, Thoracic, Transplantation, and Vascular Surgery, Germany; Integrated Research and Treatment Center Transplantation, Hannover Medical School, Hannover, Germany; University of Witten, Faculty of Health, Witten, Germany. Electronic address: christiane.kugler@uni-wh.de.
authors: Christiane
authors: C
authors: Kugler
authors: Division of Cardiac, Thoracic, Transplantation, and Vascular Surgery, Germany.
authors: Christoph
authors: C
authors: Bara
authors: Clinic for Psychosomatic Medicine, Henriettenstiftung, Hannover, Germany.
authors: Thea
authors: T
authors: von Waldthausen
authors: Division of Cardiac, Thoracic, Transplantation, and Vascular Surgery, Germany; Integrated Research and Treatment Center Transplantation, Hannover Medical School, Hannover, Germany.
authors: Ina
authors: I
authors: Einhorn
authors: mediStatistica, Neuenrade, Germany.
authors: Burkhard
authors: B
authors: Haastert
authors: Division of Cardiac, Thoracic, Transplantation, and Vascular Surgery, Germany.
authors: Christine
authors: C
authors: Fegbeutel
authors: Division of Cardiac, Thoracic, Transplantation, and Vascular Surgery, Germany.
authors: Axel
authors: A
authors: Haverich
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D057566:Self Report; D017741:Survivors; D013997:Time Factors
keywords: Chronic artery vasculopathy; Depression symptoms; Heart transplantation; Quality of life