Key result
Sacubitril/valsartan is linked to a ~64% reduction in significant depressive symptoms in advanced HF.
Why the study?
Depression is highly prevalent in HF, but the prospective effect of sacubitril/valsartan on depression in advanced HF patients on the heart transplant waiting list was unknown.
Does sacubitril/valsartan reduce depression in patients with advanced heart failure on the transplant waiting list?
Cohort (n=37)
Does sacubitril/valsartan reduce depression in patients with advanced heart failure on the transplant waiting list?
Treatment with sacubitril/valsartan in advanced heart failure patients awaiting transplant is associated with a reduction in depressive symptoms and improved functional capacity.
Should not yet change practice for depression in advanced HF; hypothesis-generating for sacubitril/valsartan effects on mood pending RCTs.
Depression is highly prevalent in Heart Failure (HF). Treatment with sacubitril/valsartan improved quality of life and survival in HF patients. Aim of the study was to investigate prospectively the effect of sacubitril/valsartan on depression in advanced HF patients in waiting list for heart transplant (HT). 37 consecutive patients with advanced HF in waiting list for HT were treated with sacubitril/valsartan. We analyzed data derived from the assessment performed the year before the beginning of sacubitril/valsartan, at study entry, and at one year of follow-up. Depression was assessed with Beck Depression Inventory II (BDI) scale. Cognitive function were assessed with Mini-Mental State Examination (MMSE). Functioning was evaluated measuring meters at 6 Minute Walking Test (6MWT) and maximum rate of oxygen consumption (VO2 max). At baseline, 64.9% of HF patients were in NYHA III and 35.1% NYHA IIIB, BDI was 15.2 ± 5.2 with 59.5% of patients with a score > 13. MMSE was 27.8 ± 2.6. After one year of follow-up NYHA class improved significantly, with 56.8% in NYHA II, 40.5% in NYHA III and 2.7% NYHA in IIIB (p < 0.001). VO2 max and 6MWT increased. Notably, BDI was 9.5 ± 3.9 with 21.6% of patients with a score > 13. MMSE remain stable (28.2 ± 2.1) (p = 0.104). No statistical differences are observed between data collected in the evaluation 1-year before and soon before treatment with sacubitril/valsartan. Multivariate regression analysis demonstrate a relationship between reduction in BDI-II score and improvement in six-minute walking test independently by the effect of sex, age, selective serotonin reuptake inhibitors, VO2 max, NT-proBNP, PAPs, NYHA class differences evaluated at follow-up versus baseline. Our study showed a reduction in depressive symptomatology in heart transplant waiting list patients treated with sacubitril/valsartan. The improvement in depressive symptomatology was paralleled by 6MWT increase in the follow-up.
No takes yet. Share an insight, caveat, or question.
Cacciatore et al. (2020) conducted a cohort in Advanced heart failure (n=37). Sacubitril/valsartan vs. Baseline (pre-treatment) was evaluated on Depression (Beck Depression Inventory II score > 13). Sacubitril/valsartan treatment in advanced heart failure patients awaiting transplant reduced the prevalence of significant depressive symptoms (BDI >13) from 59.5% at baseline to 21.6% at one year.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: