Depression, sex alter advanced heart failure symptom burden
Depression appears to increase symptom burden in patients with advanced heart failure (HF), a recent study has found. Burden also seems to be differentiated according to sex.
Researchers enrolled 347 patients with advanced HF (mean age, 66 years; 65 percent male), comparing symptom burden between males and females and between participants with and without depression. The Memorial Symptom Assessment Scale-HF (MSAS-HF) was used to measure symptom burden, while depression was assessed using the Patient Health Questionnaire.
The number of symptoms reported in the overall sample ranged from 0–32, yielding a mean of 13.6±6.8. The most common symptom was pain other than chest pain, which was experienced by 77 percent of the participants. This was followed by shortness of breath (76 percent), lack of energy (76 percent), drowsiness (52 percent), numbness/tingling (60 percent), dry mouth (60 percent) and sleep difficulties (59 percent).
The mean MSAS-HF burden score was 96±58. This was significantly higher in patients with greater depression scores (median, 137 vs 70; p=0.001).
Symptom burden also appeared to be differentially distributed according to sex. Relative to males, females had significantly greater burden of pain other than chest pain (p=0.005), dry mouth (p=0.022), feeling nervous (p=0.041), sweats (p=0.043), vomiting (p=0.015), swelling of the arms and legs (p=0.015), and nausea (p=0.0021).
On the other hand, men reported experiencing significantly greater sexual problems (p≤0.001). No significant differential sex effect was observed for the total symptom burden score (p=0.141).