In patients with stable heart failure, soluble TNF-receptor 2 is associated with increased risk for depressive symptoms

Samira Moughrabi, Lorraine Evangelista, Samer I. Habib, Leo Kassabian, Elizabeth Crabb Breen, Adeline Nyamathi, Michael Irwin

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: Researchers have proposed biological (inflammation) and psychological (depression) factors as potential mechanisms for poorer outcomes and readmissions in heart failure (HF) patients. However, studies investigating the link between inflammation and depressive symptoms in these patients are few. We examined the relationships between levels of the inflammatory markers C-reactive protein (CRP), interleukin (IL)-6, and soluble tumor necrosis factor receptor 2 (sTNR2) and depressive symptoms in HF outpatients. Method: 55 patients (74.5% men; 60% Whites; mean age 71.6 ± 11.3 years) with New York Heart Association Class II, III, or IV HF (49%, 47%, and 4%, respectively) and mean ejection fraction (EF) 29.9 ± 7.1% completed the Patient Health Questionnaire (PHQ)-9 as a measure of depressive symptoms. We also obtained height, weight, and CRP, IL-6, and sTNFR2 levels. We used multivariate regressions to assess the predictive value of PHQ-9 scores on each inflammatory marker. Results: 22 (40%) participants reported depressive symptoms (PHQ-9 score ≥ 5). After controlling for age, gender, body mass index, HF etiology, EF, and statin use, we found significant relationships between levels of both sTNFR2 (β =.35, p =.01) and IL-6 (β =.30, p =.04), but not CRP (β=_.96, p =.52), and depression scores. Conclusion: Our findings add to a growing body of evidence supporting the proposition that heightened inflammation explains the effect depression has on HF. Health care providers should screen for depression in HF patients, as they may be at higher risk of augmented inflammation and poor outcomes.

Original languageEnglish (US)
Pages (from-to)295-302
Number of pages8
JournalBiological research for nursing
Volume16
Issue number3
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Tumor Necrosis Factor Receptors
Heart Failure
Depression
C-Reactive Protein
Inflammation
Interleukin-6
Health
Receptors, Tumor Necrosis Factor, Type II
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Health Personnel
Body Mass Index
Outpatients
Research Personnel
Psychology
Weights and Measures

Keywords

  • CRP
  • Depressive symptoms
  • Heart failure
  • IL-6
  • Inflammation
  • TNF-receptors
  • TNF-α

ASJC Scopus subject areas

  • Research and Theory

Cite this

In patients with stable heart failure, soluble TNF-receptor 2 is associated with increased risk for depressive symptoms. / Moughrabi, Samira; Evangelista, Lorraine; Habib, Samer I.; Kassabian, Leo; Breen, Elizabeth Crabb; Nyamathi, Adeline; Irwin, Michael.

In: Biological research for nursing, Vol. 16, No. 3, 01.01.2014, p. 295-302.

Research output: Contribution to journalArticle

Moughrabi, Samira ; Evangelista, Lorraine ; Habib, Samer I. ; Kassabian, Leo ; Breen, Elizabeth Crabb ; Nyamathi, Adeline ; Irwin, Michael. / In patients with stable heart failure, soluble TNF-receptor 2 is associated with increased risk for depressive symptoms. In: Biological research for nursing. 2014 ; Vol. 16, No. 3. pp. 295-302.
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abstract = "Objectives: Researchers have proposed biological (inflammation) and psychological (depression) factors as potential mechanisms for poorer outcomes and readmissions in heart failure (HF) patients. However, studies investigating the link between inflammation and depressive symptoms in these patients are few. We examined the relationships between levels of the inflammatory markers C-reactive protein (CRP), interleukin (IL)-6, and soluble tumor necrosis factor receptor 2 (sTNR2) and depressive symptoms in HF outpatients. Method: 55 patients (74.5{\%} men; 60{\%} Whites; mean age 71.6 ± 11.3 years) with New York Heart Association Class II, III, or IV HF (49{\%}, 47{\%}, and 4{\%}, respectively) and mean ejection fraction (EF) 29.9 ± 7.1{\%} completed the Patient Health Questionnaire (PHQ)-9 as a measure of depressive symptoms. We also obtained height, weight, and CRP, IL-6, and sTNFR2 levels. We used multivariate regressions to assess the predictive value of PHQ-9 scores on each inflammatory marker. Results: 22 (40{\%}) participants reported depressive symptoms (PHQ-9 score ≥ 5). After controlling for age, gender, body mass index, HF etiology, EF, and statin use, we found significant relationships between levels of both sTNFR2 (β =.35, p =.01) and IL-6 (β =.30, p =.04), but not CRP (β=_.96, p =.52), and depression scores. Conclusion: Our findings add to a growing body of evidence supporting the proposition that heightened inflammation explains the effect depression has on HF. Health care providers should screen for depression in HF patients, as they may be at higher risk of augmented inflammation and poor outcomes.",
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AU - Breen, Elizabeth Crabb

AU - Nyamathi, Adeline

AU - Irwin, Michael

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AB - Objectives: Researchers have proposed biological (inflammation) and psychological (depression) factors as potential mechanisms for poorer outcomes and readmissions in heart failure (HF) patients. However, studies investigating the link between inflammation and depressive symptoms in these patients are few. We examined the relationships between levels of the inflammatory markers C-reactive protein (CRP), interleukin (IL)-6, and soluble tumor necrosis factor receptor 2 (sTNR2) and depressive symptoms in HF outpatients. Method: 55 patients (74.5% men; 60% Whites; mean age 71.6 ± 11.3 years) with New York Heart Association Class II, III, or IV HF (49%, 47%, and 4%, respectively) and mean ejection fraction (EF) 29.9 ± 7.1% completed the Patient Health Questionnaire (PHQ)-9 as a measure of depressive symptoms. We also obtained height, weight, and CRP, IL-6, and sTNFR2 levels. We used multivariate regressions to assess the predictive value of PHQ-9 scores on each inflammatory marker. Results: 22 (40%) participants reported depressive symptoms (PHQ-9 score ≥ 5). After controlling for age, gender, body mass index, HF etiology, EF, and statin use, we found significant relationships between levels of both sTNFR2 (β =.35, p =.01) and IL-6 (β =.30, p =.04), but not CRP (β=_.96, p =.52), and depression scores. Conclusion: Our findings add to a growing body of evidence supporting the proposition that heightened inflammation explains the effect depression has on HF. Health care providers should screen for depression in HF patients, as they may be at higher risk of augmented inflammation and poor outcomes.

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