Associations of mood symptoms with NYHA functional classes in angina pectoris patients: a cross-sectional study View Full Text


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Article Info

DATE

2019-12

AUTHORS

Han Yin, Yuting Liu, Huan Ma, Guihao Liu, Lan Guo, Qingshan Geng

ABSTRACT

BACKGROUND: Depression and anxiety are prevalent and associated with a worse prognosis in coronary heart disease (CHD) patients. However, the influence of disease severity on mood symptoms is unknown. The specific associations of mood symptoms with NYHA classes remain unexplored. METHODS: In this cross-sectional study, 443 consecutive inpatients with angina pectoris (AP) confirmed by angiography were included into analysis. Somatic and cognitive symptom scores derived from Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) were used to assess mood symptoms. Predictors for depression and anxiety with strict and lax standards were compared. We hypothesized NYHA classification to be an indicator of disease severity through analyses with clinical features using ordinal logistic model. Applying both binary and ordinal logistic models, we evaluated the associations of mood symptoms with NYHA classes. RESULTS: Discrepancy of disease severity existed between the depressed and nondepressed. NYHA classification was proved to be an integrated index under influence of age, coronary stenosis, heart failure and diabetes. NYHA class I and II individuals with AP were at equivalent risk for depression (NYHA II vs I: binary model OR 1.32 (0.59,2.96), p = 0.50; ordinal model OR 1.17 (0.73,1.88), p = 0.52), however NYHA class III/IV patients shared a sharply higher risk (NYHA III/IV vs I: binary model OR 3.32 (1.28,8.61), p = .013; ordinal model OR 3.94 (2.11,7.36), p < .001). Analyses on somatic and cognitive depressive symptoms confirmed this finding and hinted a greater impact of education background on mood when patient's condition is unstable. Anxiety seemed in the whole picture irrelevant with NYHA classes. Comparing with NYHA class I/II, AP patients in NYHA class III/IV tended to be less anxious. However, when CHD became unstable, the calmness may immediately be broken up. A great distinction of the ratio of anxiety and depression symptom scores between NYHA class III/IV stable and unstable AP patients (p = .018) was observed. CONCLUSIONS: Mood symptoms in CHD patients are to a great extend derived from disease itself. Only for patients with relatively serious physical condition, unexpected discomforts caused by disease notably impact the emotions. Education background tends to influence the mood especially when disease is still unstable. More... »

PAGES

85

References to SciGraph publications

  • 2017-03. Depression and coronary heart disease in NATURE REVIEWS CARDIOLOGY
  • 2001-09. The PHQ-9 in JOURNAL OF GENERAL INTERNAL MEDICINE
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    URI

    http://scigraph.springernature.com/pub.10.1186/s12888-019-2061-3

    DOI

    http://dx.doi.org/10.1186/s12888-019-2061-3

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1112548024

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30836983


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        "description": "BACKGROUND: Depression and anxiety are prevalent and associated with a worse prognosis in coronary heart disease (CHD) patients. However, the influence of disease severity on mood symptoms is unknown. The specific associations of mood symptoms with NYHA classes remain unexplored.\nMETHODS: In this cross-sectional study, 443 consecutive inpatients with angina pectoris (AP) confirmed by angiography were included into analysis. Somatic and cognitive symptom scores derived from Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) were used to assess mood symptoms. Predictors for depression and anxiety with strict and lax standards were compared. We hypothesized NYHA classification to be an indicator of disease severity through analyses with clinical features using ordinal logistic model. Applying both binary and ordinal logistic models, we evaluated the associations of mood symptoms with NYHA classes.\nRESULTS: Discrepancy of disease severity existed between the depressed and nondepressed. NYHA classification was proved to be an integrated index under influence of age, coronary stenosis, heart failure and diabetes. NYHA class I and II individuals with AP were at equivalent risk for depression (NYHA II vs I: binary model OR 1.32 (0.59,2.96), p\u2009=\u20090.50; ordinal model OR 1.17 (0.73,1.88), p\u2009=\u20090.52), however NYHA class III/IV patients shared a sharply higher risk (NYHA III/IV vs I: binary model OR 3.32 (1.28,8.61), p\u2009=\u2009.013; ordinal model OR 3.94 (2.11,7.36), p\u2009<\u2009.001). Analyses on somatic and cognitive depressive symptoms confirmed this finding and hinted a greater impact of education background on mood when patient's condition is unstable. Anxiety seemed in the whole picture irrelevant with NYHA classes. Comparing with NYHA class I/II, AP patients in NYHA class III/IV tended to be less anxious. However, when CHD became unstable, the calmness may immediately be broken up. A great distinction of the ratio of anxiety and depression symptom scores between NYHA class III/IV stable and unstable AP patients (p\u2009=\u2009.018) was observed.\nCONCLUSIONS: Mood symptoms in CHD patients are to a great extend derived from disease itself. Only for patients with relatively serious physical condition, unexpected discomforts caused by disease notably impact the emotions. Education background tends to influence the mood especially when disease is still unstable.", 
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    Download the RDF metadata as:  json-ld nt turtle xml License info

    HOW TO GET THIS DATA PROGRAMMATICALLY:

    JSON-LD is a popular format for linked data which is fully compatible with JSON.

    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1186/s12888-019-2061-3'

    N-Triples is a line-based linked data format ideal for batch operations.

    curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1186/s12888-019-2061-3'

    Turtle is a human-readable linked data format.

    curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1186/s12888-019-2061-3'

    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/s12888-019-2061-3'


     

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