Association of depression symptoms with quality of life and chronic artery vasculopathy: a cross-sectional study in heart transplant patients

Objective: Depression represents a relevant co-morbidity in patients with chronic heart disease and may diminish the overall success for long-term survival after heart transplantation (HTx). This study aimed to assess the prevalence of depression symptoms in long-term HTx survivors, and to compare depressive patients to those without depression with respect to chronic artery vasculopathy (CAV).

Methods: A sample of 203 HTx patients, median 11.5 (IQR 7-17) years after transplant, provided detailed data of depression symptoms, and other psychosocial symptoms including anxiety, family support, professional re-integration, and health-related quality of life (HRQoL). Data were analyzed for an association with CAV.

Results: Overall, 14.8% patients (95% CI: 10.2-20.4) showed relevant depression symptoms. No significant differences were seen between non-depressed vs. depressed patients with respect to demographics, clinical variables, and cardiovascular risk factors. Anxiety was prevalent in 9.0% (95% CI: 5.4-13.9) of the sample. Depression symptoms showed impaired HRQoL in the SF-36 physical (P=.012) and psychosocial (P=.0001) components. CAV was prevalent in 34.0% (95% CI: 27.5-41.0), and depression symptoms and CAV were not significantly associated. CAV-patients did not report their physical HRQoL being lower relative to those without CAV (P=.40). Multivariate analysis revealed overweight BMI (OR=2.20; P=.04), longer time since transplant (OR=1.10; P=.001), and older age (OR=1.04; P=.01) being associated with CAV.

Conclusion: Depression symptoms are prevalent in long-term survivors after HTx, and psychological impairments decrease patients' perceptions of HRQoL. More research seems necessary to identify the inter-relationship between depression symptoms and CAV, in order to develop targeted interventions to overcome this problem.