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The Association Between Depressive Symptoms and N-Terminal Pro-B-Type Natriuretic Peptide With Functional Status in

Zyad T Saleh1, Jia-Rong Wu, Ibrahim Salami

  • 1Zyad T. Saleh, PhD, RN Assistant Professor, School of Nursing, The University of Jordan, Amman. Jia-Rong Wu, PhD, RN Assistant Professor, School of Nursing, University of North Carolina, Chapel Hill. Ibrahim Salami, PhD, RN Assistant Professor, School of Nursing, The University of Jordan, Amman. Khalil Yousef, PhD, RN Assistant Professor, School of Nursing, The University of Jordan, Amman. Terry A. Lennie, PhD, RN, FAAN Professor, Senior Associate Dean, and Co-Director of the RICH Heart Program, College of Nursing, University of Kentucky, Lexington.

The Journal of Cardiovascular Nursing
|February 14, 2018
PubMed

Insights

Depressive symptoms, not NT-proBNP levels, predict functional status in heart failure (HF) patients. Addressing depression may improve functional status irrespective of HF severity.

Area of Science:

  • Cardiology
  • Psychiatry
  • Health Outcomes Research

Background:

  • N-terminal pro-B-type natriuretic peptide (NT-proBNP) and depressive symptoms are independently linked to functional status in heart failure (HF).
  • The combined impact of NT-proBNP and depressive symptoms on functional status in HF patients remains underexplored.

Purpose of the Study:

  • To investigate the interplay between NT-proBNP levels and depressive symptoms in predicting functional status among HF patients.
  • To determine which factor, NT-proBNP or depressive symptoms, is a stronger predictor of functional status when considered together.

Main Methods:

  • A cohort of 284 HF patients was categorized into four groups based on median NT-proBNP levels and a depression cut-off (Beck Depression Inventory ≥ 14).
  • Functional status was assessed using the Duke Activity Status Index.
  • Nonlinear regression analysis was employed to evaluate the associations, controlling for covariates like age, gender, antidepressant use, and BMI.

Main Results:

  • Patients without depressive symptoms demonstrated more than double the likelihood of having better functional status compared to those with depressive symptoms, irrespective of NT-proBNP levels.
  • In the presence of depressive symptoms, no significant difference in functional status was observed between patients with low versus high NT-proBNP levels.
  • Depressive symptoms emerged as a significant predictor of functional status, overshadowing the predictive value of NT-proBNP levels.

Conclusions:

  • Depressive symptoms, rather than NT-proBNP levels, are the primary determinant of functional status when considered concurrently in heart failure patients.
  • Targeting and effectively treating depressive symptoms in HF patients could lead to substantial improvements in functional status, regardless of the underlying HF severity or NT-proBNP levels.
Abstract

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