Leukocyte ß-adrenergic receptor sensitivity and depression severity in patients with heart failure.
OBJECTIVE
Clinical outcomes are worse for patients with heart failure (HF) and elevated depression symptoms. Depression-related sympathoimmune dysregulation may be one mechanism leading to poorer HF prognosis. Sympathetically mediated adrenergic activity is known to regulate immune activity via β-adrenergic receptors (β-ARs). However, studies show conflicting relationships between leukocyte β-AR sensitivity and depression symptoms. The aim of this study was to determine in patients with HF the relationship of leukocyte β-AR sensitivity with two diverse measures of depression, self-report questionnaire versus clinical diagnostic interview.


METHODS
Patients with HF (N = 73, mean [standard deviation] age = 56.3 [13.0]) completed the Beck Depression Inventory-1A and a modified Structured Clinical Interview for the DSM-IV. Leukocyte β-AR sensitivity was determined from isoproterenol-stimulated cyclic adenosine monophosphate levels; plasma norepinephrine and epinephrine were also assessed.


RESULTS
Patients with major depression determined by Structured Clinical Interview for the DSM-IV had significantly higher β-AR sensitivity than did nondepressed patients (F(6,72) = 9.27, p = .003, η = 0.12). The Beck Depression Inventory-1A revealed a more complex relationship. Minimal, mild, and moderate-to-severe depression symptom groups had significant differences in β-AR sensitivity (F(7,72) = 7.03, p = .002, η = 0.18); mild symptoms were associated with reduced β-AR sensitivity and moderate-to-severe symptoms with higher β-AR sensitivity compared with patients with minimal depressive symptoms.


CONCLUSIONS
Clinical depression was associated with elevated β-AR sensitivity in patients with HF. By deconstructing depression measurements, a greater depth of information may be garnered to potentially reveal subtypes of depression symptoms and their relation to β-AR sensitivity.
From the Departments of Psychiatry (L.S.R., S.H., T.R., B.W., M.P., P.J.M.), and Department of Medicine (M.G.Z., A.M., B.G.), University of California, San Diego, La Jolla, California; and Research Services (L.S.R., T.R., A.M.), VA San Diego Healthcare System, La Jolla, California.
Laura S
LS
Redwine
Suzi
S
Hong
Thomas
T
Rutledge
Bailey
B
Wentworth
Meredith
M
Pung
Michael G
MG
Ziegler
Alan
A
Maisel
Barry
B
Greenberg
Paul J
PJ
Mills
D000328:Adult; D000368:Aged; D003863:Depression / Q000097:blood*; D003865:Major Depressive Disorder / Q000097:blood*; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D007962:Leukocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011943:Receptors, Adrenergic, beta; D012720:Severity of Illness Index
D011943:Receptors, Adrenergic, beta