The Association between Depressive Symptoms and N-Terminal Pro-B-Type Natriuretic Peptide with Functional Status in Patients with Heart Failure

Zyad T. Saleh; Jia Rong Wu; Ibrahim Salami; Khalil Yousef; Terry A. Lennie

doi:10.1097/JCN.0000000000000470

The Association between Depressive Symptoms and N-Terminal Pro-B-Type Natriuretic Peptide with Functional Status in Patients with Heart Failure

Zyad T. Saleh, Jia Rong Wu, Ibrahim Salami, Khalil Yousef, Terry A. Lennie

College of Nursing

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and depressive symptoms are each associated with functional status in patients with heart failure (HF), but their association together with functional status has not been examined. Objective: The aim of this study was to determine whether functional status scores differ as a function of depressive symptoms and NT-proBNP levels considered together. Methods: We studied 284 patients with HF who were divided into 4 groups based on the median split of NT-proBNP levels and cut point for depressive symptoms (Beck Depression Inventory ≥ 14): (1) low NT-proBNP of 562.5 pg/mL or less without depressive symptoms, (2) low NT-proBNP of 562.5 pg/mL or less with depressive symptoms, (3) high NT-proBNP of greater than 562.5 pg/mL without depressive symptoms, and (4) high NT-proBNP of greater than 562.5 pg/mL with depressive symptoms. The Duke Activity Status Index was used to assess functional status. Results: Nonlinear regression demonstrated that patients without depressive symptoms were more than twice as likely to have higher (better) functional status scores than patients with depressive symptoms regardless of NT-proBNP levels after controlling for age, gender, prescribed antidepressants, and body mass index. Functional status levels of patients with low NT-proBNP did not differ from those with high NT-proBNP in the presence of depressive symptoms. Conclusion: When examined together, depressive symptoms rather than NT-proBNP levels predicted functional status. Clinical Implications: Adequate treatment of depressive symptoms may lead to better functional status regardless of HF severity.

Original language	English
Pages (from-to)	378-383
Number of pages	6
Journal	Journal of Cardiovascular Nursing
Volume	33
Issue number	4
DOIs	https://doi.org/10.1097/JCN.0000000000000470
State	Published - Jul 1 2018

Bibliographical note

Publisher Copyright:
© 2018 Lippincott Williams and Wilkins. All rights reserved.

Funding

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. This work was supported by the National Institutes of Health, National Institute of Nursing Research, RO1 NR013430 to T.A.L. and RO1 NR008567, 1R01NR016824, and 1R01NR014189 to Debra Moser. The authors have no conflicts of interest to disclose. Correspondence Zyad T. Saleh, PhD, Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, Jordan 11942 ([email protected]).

Funders	Funder number
National Institutes of Health (NIH)
National Institute of Health National Institute of Nursing Research	1R01NR016824, RO1 NR008567, R01NR009280, 1R01NR014189, RO1 NR013430
National Institute of Health National Institute of Nursing Research

Keywords

N-terminal pro-B-type natriuretic peptide
depressive symptoms
functional status
heart failure

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Advanced and Specialized Nursing

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10.1097/JCN.0000000000000470

Cite this

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title = "The Association between Depressive Symptoms and N-Terminal Pro-B-Type Natriuretic Peptide with Functional Status in Patients with Heart Failure",

abstract = "Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and depressive symptoms are each associated with functional status in patients with heart failure (HF), but their association together with functional status has not been examined. Objective: The aim of this study was to determine whether functional status scores differ as a function of depressive symptoms and NT-proBNP levels considered together. Methods: We studied 284 patients with HF who were divided into 4 groups based on the median split of NT-proBNP levels and cut point for depressive symptoms (Beck Depression Inventory ≥ 14): (1) low NT-proBNP of 562.5 pg/mL or less without depressive symptoms, (2) low NT-proBNP of 562.5 pg/mL or less with depressive symptoms, (3) high NT-proBNP of greater than 562.5 pg/mL without depressive symptoms, and (4) high NT-proBNP of greater than 562.5 pg/mL with depressive symptoms. The Duke Activity Status Index was used to assess functional status. Results: Nonlinear regression demonstrated that patients without depressive symptoms were more than twice as likely to have higher (better) functional status scores than patients with depressive symptoms regardless of NT-proBNP levels after controlling for age, gender, prescribed antidepressants, and body mass index. Functional status levels of patients with low NT-proBNP did not differ from those with high NT-proBNP in the presence of depressive symptoms. Conclusion: When examined together, depressive symptoms rather than NT-proBNP levels predicted functional status. Clinical Implications: Adequate treatment of depressive symptoms may lead to better functional status regardless of HF severity.",

keywords = "N-terminal pro-B-type natriuretic peptide, depressive symptoms, functional status, heart failure",

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AU - Wu, Jia Rong

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AU - Yousef, Khalil

AU - Lennie, Terry A.

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and depressive symptoms are each associated with functional status in patients with heart failure (HF), but their association together with functional status has not been examined. Objective: The aim of this study was to determine whether functional status scores differ as a function of depressive symptoms and NT-proBNP levels considered together. Methods: We studied 284 patients with HF who were divided into 4 groups based on the median split of NT-proBNP levels and cut point for depressive symptoms (Beck Depression Inventory ≥ 14): (1) low NT-proBNP of 562.5 pg/mL or less without depressive symptoms, (2) low NT-proBNP of 562.5 pg/mL or less with depressive symptoms, (3) high NT-proBNP of greater than 562.5 pg/mL without depressive symptoms, and (4) high NT-proBNP of greater than 562.5 pg/mL with depressive symptoms. The Duke Activity Status Index was used to assess functional status. Results: Nonlinear regression demonstrated that patients without depressive symptoms were more than twice as likely to have higher (better) functional status scores than patients with depressive symptoms regardless of NT-proBNP levels after controlling for age, gender, prescribed antidepressants, and body mass index. Functional status levels of patients with low NT-proBNP did not differ from those with high NT-proBNP in the presence of depressive symptoms. Conclusion: When examined together, depressive symptoms rather than NT-proBNP levels predicted functional status. Clinical Implications: Adequate treatment of depressive symptoms may lead to better functional status regardless of HF severity.

AB - Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and depressive symptoms are each associated with functional status in patients with heart failure (HF), but their association together with functional status has not been examined. Objective: The aim of this study was to determine whether functional status scores differ as a function of depressive symptoms and NT-proBNP levels considered together. Methods: We studied 284 patients with HF who were divided into 4 groups based on the median split of NT-proBNP levels and cut point for depressive symptoms (Beck Depression Inventory ≥ 14): (1) low NT-proBNP of 562.5 pg/mL or less without depressive symptoms, (2) low NT-proBNP of 562.5 pg/mL or less with depressive symptoms, (3) high NT-proBNP of greater than 562.5 pg/mL without depressive symptoms, and (4) high NT-proBNP of greater than 562.5 pg/mL with depressive symptoms. The Duke Activity Status Index was used to assess functional status. Results: Nonlinear regression demonstrated that patients without depressive symptoms were more than twice as likely to have higher (better) functional status scores than patients with depressive symptoms regardless of NT-proBNP levels after controlling for age, gender, prescribed antidepressants, and body mass index. Functional status levels of patients with low NT-proBNP did not differ from those with high NT-proBNP in the presence of depressive symptoms. Conclusion: When examined together, depressive symptoms rather than NT-proBNP levels predicted functional status. Clinical Implications: Adequate treatment of depressive symptoms may lead to better functional status regardless of HF severity.

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The Association between Depressive Symptoms and N-Terminal Pro-B-Type Natriuretic Peptide with Functional Status in Patients with Heart Failure

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

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