title: Major depressive disorder in chronic heart failure patients: Does silent cerebral infarction cause major depressive disorder in this patient population?
abstract: OBJECTIVE
  Depression frequently occurs in patients with heart failure as similar pathophysiological mechanisms present in both these diseases. Patients with dilated cardiomyopathy (DCM) have a high incidence of clinically asymptomatic silent cerebral infarction (SCI). This study aimed to evaluate the relation between SCI and major depressive disorder (MDD), and between MDD and clinical and biochemical parameters in DCM patients.
  
  
  METHODS
  Patients with ischemic and non-ischemic DCM who had chronic heart failure (CHF) (39 male, 10 female, age 60±10 years) were included in the study. Mean patient ejection fraction (EF) was 34±10%. Patients had no localized neurological symptoms or stroke history. The etiology of DCM was ischemic in 40 and non-ischemic in 9 patients. Twenty-five age-matched healthy volunteers served as a control group for comparison of SCI and MDD prevalence.
  
  
  RESULTS
  Patients had mild to severe CHF symptoms. Prevalence of SCI and MDD was significantly higher in patients with DCM than in the control group; 63% vs 8%; p<0.001, and 52% vs 20%; p<0.001 respectively. Patients with SCI had a higher prevalence of MDD than patients without SCI in DCM (61% vs 27%, p=0.02).
  
  
  CONCLUSIONS
  CHF patients have an increased prevalence of SCI and MDD. Patients with SCI have a higher prevalence of MDD compared to patients without SCI in CHF.
authors.affiliation: Department of Cardiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Güliz
authors.initials: G
authors.lastname: Kozdağ
authors.affiliation: Department of Psychiatry, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: İrem
authors.initials: İ
authors.lastname: Yaluğ
authors.affiliation: Department of Radiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Nagihan
authors.initials: N
authors.lastname: İnan
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Ertaş
authors.affiliation: Department of Neurology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Macit
authors.initials: M
authors.lastname: Selekler
authors.affiliation: Department of Psychiatry, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Kutlu
authors.affiliation: Department of Neurology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Kutlu
authors.affiliation: Department of Cardiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Ender
authors.initials: E
authors.lastname: Emre
authors.affiliation: Department of Cardiology, Central Hospital, Kocaeli, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Çetin
authors.affiliation: Department of Cardiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Ural
mesh_terms: D016022:Case-Control Studies; D002544:Cerebral Infarction / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D003866:Depressive Disorder / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D014421:Turkey / Q000453:epidemiology