Symptoms, depression, and quality of life in patients with heart failure
Symptoms, depression, and quality of life in patients with heart failure
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DOI：
10.1016/j.cardfail.2007.05.005
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发表时间：
2007-10-01
影响因子：
6
通讯作者：
Dy, Sydney M.
中科院分区：
文献类型：
--
作者：
Bekelman, David B.;Havranek, Edward P.;Dy, Sydney M.
背景：对于慢性心力衰竭门诊患者的症状及其负担知之甚少。多种症状可能与心力衰竭相关生活质量差有关，而抑郁可能与症状增加有关。
方法和结果：对来自两个心内科门诊的60例心力衰竭患者进行横断面测量，测量指标包括症状数量和症状困扰（纪念症状评估量表 - 简表中的躯体症状）、抑郁（老年抑郁量表 - 简表）以及心力衰竭相关生活质量（堪萨斯城心肌病问卷）。患者在前一周平均出现9种症状。超过一半的患者报告有呼吸急促、乏力、疼痛、嗜睡或口干。在未经调整的分析中，更严重的抑郁与更多的症状数量（r = 0.51，P <.0001）以及更严重的总体症状困扰（r = 0.58，P <.0001）相关。在对年龄、种族和N末端脑利钠肽前体进行调整后，每增加一种抑郁症状，报告的症状数量增加0.6（P =.01）。症状数量占生活质量变异的32%（P <.0001）。
结论：心力衰竭患者报告有大量令人痛苦的症状。心力衰竭患者的抑郁与更多的症状相关，而这反过来又与心力衰竭相关生活质量下降有关。治疗心力衰竭患者的抑郁以及他们所报告的多种症状可能会显著提高生活质量。
Background: Little is known about symptoms and their burden ill outpatients with chronic heart failure. Diverse symptoms may be associated with poor heart failure-related quality of life, and depression may be related to increased symptoms.Methods and Results: The number of symptoms and symptom distress (physical symptoms oil the Memorial Symptom Assessment Scale-Short Form), depression (Geriatric Depression Scale-Short Form),and heart fail Lire-related quality of life (Kansas City cardiomyopathy Questionnaire) were measured cross-sectionally ill 60 patients with heart failure from two Outpatient cardiology clinics. Patients experienced a mean of nine symptoms in the previous week. More than half reported shortness of breath, lack of energy, pain, feeling drowsy, or (try mouth. Ill unadjusted analyses, more severe depression was associated with a greater number of symptoms (r = 0.5 1, P < .0001) and greater overall symptom distress (r = 0.58, P < .0001). For each additional depression symptom, the number of symptoms reported increased by 0.6 after adjustment for age, race, and N-terminal pro-brain natriuretic peptide (P = .01). The number of symptoms accounted for 32% of the variance in quality of life (P < .0001).Conclusions: Patients with heart failure report a large number of distressing symptoms. Depression in patients with heart failure is associated with a greater number of symptoms, which in turn is associated with a decrease in heart failure-related quality of life. Treatment of depression and the diverse symptoms reported by patients with heart failure might significantly improve quality of life.