Skip to main content
Erschienen in: Herz 8/2016

17.10.2016 | Herzinsuffizienz | CME

Depression und Herzinsuffizienz – doppeltes Risiko?

Diagnostik, prognostische Bedeutung und Therapie einer unterschätzten Komorbidität

verfasst von: J. Wallenborn, Prof. Dr. med. C. E. Angermann

Erschienen in: Herz | Ausgabe 8/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

Herzinsuffizienz und Depression sind Volkskrankheiten von besonderer klinischer und ökonomischer Relevanz. Verglichen mit der Normalbevölkerung findet sich bei Patienten mit Herzinsuffizienz eine komorbide Depression bis zu 5‑mal häufiger. Dies hat negative Auswirkungen auf die Morbidität, Mortalität, Lebensqualität und Behandlungskosten. Depressive Symptome überlappen mit denen der Herzinsuffizienz, was die Diagnose erschwert. Wenig aufwendige Screening-Instrumente, z. B. der 2‑Item-Gesundheitsfrageborgen für Depression, erleichtern im klinischen Alltag die Erkennung. Bisher gibt es keine Evidenz aus randomisierten kontrollierten Studien, dass Antidepressiva bei Herzinsuffizienz Stimmung und Prognose verbessern können, sodass deren Einsatz eine Einzelfallentscheidung bleiben sollte. Durch körperliches Training, kognitive Verhaltenstherapie und multidisziplinäre ganzheitliche Betreuungskonzepte wurden in einzelnen randomisierten Studien depressive Symptome und/oder Prognose gebessert.
Literatur
7.
Zurück zum Zitat Lichtman JH, Bigger JT Jr., Blumenthal JA et al (2008) Depression and coronary heart disease: recommendations for screening, referral, and treatment: A science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association. Circulation 118(17):1768–1775. doi:10.1161/CIRCULATIONAHA.108.190769 CrossRefPubMed Lichtman JH, Bigger JT Jr., Blumenthal JA et al (2008) Depression and coronary heart disease: recommendations for screening, referral, and treatment: A science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association. Circulation 118(17):1768–1775. doi:10.​1161/​CIRCULATIONAHA.​108.​190769 CrossRefPubMed
11.
Zurück zum Zitat World Health Organization (1992) ICD-10 Classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. World Health Organization, Geneva World Health Organization (1992) ICD-10 Classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. World Health Organization, Geneva
12.
Zurück zum Zitat American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). American Psychiatric Publishing, Arlington VACrossRef American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). American Psychiatric Publishing, Arlington VACrossRef
15.
Zurück zum Zitat American Heart Association (2005) Heart disease and stroke statistics – 2005 update. American Heart Association, Dallas American Heart Association (2005) Heart disease and stroke statistics – 2005 update. American Heart Association, Dallas
17.
Zurück zum Zitat Vos T, Flaxman AD, Naghavi M et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2163–2196. doi:10.1016/S0140-6736(12)61729-2 CrossRefPubMed Vos T, Flaxman AD, Naghavi M et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2163–2196. doi:10.​1016/​S0140-6736(12)61729-2 CrossRefPubMed
18.
Zurück zum Zitat Busch MA, Maske UE, Ryl L et al (2013) Prevalence of depressive symptoms and diagnosed depression among adults in Germany: Results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 56(5–6):733–739. doi:10.1007/s00103-013-1688-3 CrossRefPubMed Busch MA, Maske UE, Ryl L et al (2013) Prevalence of depressive symptoms and diagnosed depression among adults in Germany: Results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 56(5–6):733–739. doi:10.​1007/​s00103-013-1688-3 CrossRefPubMed
19.
Zurück zum Zitat Vaccarino V, Kasl SV, Abramson J (2001) Depressive symptoms and risk of functional decline and death in patients with heart failure. J Am Coll Cardiol 38(1):199–205CrossRefPubMed Vaccarino V, Kasl SV, Abramson J (2001) Depressive symptoms and risk of functional decline and death in patients with heart failure. J Am Coll Cardiol 38(1):199–205CrossRefPubMed
28.
Zurück zum Zitat Rozanski A, Blumenthal JA, Davidson KW et al (2005) The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: The emerging field of behavioral cardiology. J Am Coll Cardiol 45(5):637–651. doi:10.1016/j.jacc.2004.12.005 CrossRefPubMed Rozanski A, Blumenthal JA, Davidson KW et al (2005) The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: The emerging field of behavioral cardiology. J Am Coll Cardiol 45(5):637–651. doi:10.​1016/​j.​jacc.​2004.​12.​005 CrossRefPubMed
29.
Zurück zum Zitat Kliks BR, Burgess MJ, Abildskov JA (1975) Influence of sympathetic tone on ventricular fibrillation threshold during experimental coronary occlusion. Am J Cardiol 36(1):45–49CrossRefPubMed Kliks BR, Burgess MJ, Abildskov JA (1975) Influence of sympathetic tone on ventricular fibrillation threshold during experimental coronary occlusion. Am J Cardiol 36(1):45–49CrossRefPubMed
30.
Zurück zum Zitat Schwartz PJ (1998) The autonomic nervous system and sudden death. Eur Heart J 19(Suppl F):F72–F80PubMed Schwartz PJ (1998) The autonomic nervous system and sudden death. Eur Heart J 19(Suppl F):F72–F80PubMed
32.
Zurück zum Zitat Wulsin LR, Singal BM (2003) Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med 65(2):201–210CrossRefPubMed Wulsin LR, Singal BM (2003) Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med 65(2):201–210CrossRefPubMed
35.
Zurück zum Zitat Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 18(8):891–975. doi:10.1002/ejhf.592 CrossRefPubMed Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 18(8):891–975. doi:10.​1002/​ejhf.​592 CrossRefPubMed
36.
Zurück zum Zitat Jiang W, Alexander J, Christopher E et al (2001) Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med 161(15):1849–1856CrossRefPubMed Jiang W, Alexander J, Christopher E et al (2001) Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med 161(15):1849–1856CrossRefPubMed
42.
Zurück zum Zitat Cohen HW, Gibson G, Alderman MH (2000) Excess risk of myocardial infarction in patients treated with antidepressant medications: Association with use of tricyclic agents. Am J Med 108(1):2–8CrossRefPubMed Cohen HW, Gibson G, Alderman MH (2000) Excess risk of myocardial infarction in patients treated with antidepressant medications: Association with use of tricyclic agents. Am J Med 108(1):2–8CrossRefPubMed
43.
Zurück zum Zitat Wallenborn J, Angermann CE (2014) Herzinsuffizienz und Depression – Eine Wechselbeziehung mit vielfältigen Facetten. Klinikarzt 43(11):524–528CrossRef Wallenborn J, Angermann CE (2014) Herzinsuffizienz und Depression – Eine Wechselbeziehung mit vielfältigen Facetten. Klinikarzt 43(11):524–528CrossRef
44.
Zurück zum Zitat Piepenburg SM, Ertl G, Angermann CE (2016) Depression und Herzinsuffizienz – eine gefährliche Kombination. Dtsch Med Wochenschr 141(17):1222–1227CrossRefPubMed Piepenburg SM, Ertl G, Angermann CE (2016) Depression und Herzinsuffizienz – eine gefährliche Kombination. Dtsch Med Wochenschr 141(17):1222–1227CrossRefPubMed
45.
46.
Zurück zum Zitat Angermann CE, Gelbrich G, Stork S et al (2016) Effect of Escitalopram on all-cause mortality and hospitalization in patients with heart failure and depression: the MOOD-HF randomized clinical trial. JAMA 315(24):2683–2693. doi:10.1001/jama.2016.7635 CrossRefPubMed Angermann CE, Gelbrich G, Stork S et al (2016) Effect of Escitalopram on all-cause mortality and hospitalization in patients with heart failure and depression: the MOOD-HF randomized clinical trial. JAMA 315(24):2683–2693. doi:10.​1001/​jama.​2016.​7635 CrossRefPubMed
48.
Zurück zum Zitat Huffman JC, Mastromauro CA, Beach SR et al (2014) Collaborative care for depression and anxiety disorders in patients with recent cardiac events: The Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized clinical trial. JAMA Intern Med 174(6):927–935. doi:10.1001/jamainternmed.2014.739 CrossRefPubMed Huffman JC, Mastromauro CA, Beach SR et al (2014) Collaborative care for depression and anxiety disorders in patients with recent cardiac events: The Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized clinical trial. JAMA Intern Med 174(6):927–935. doi:10.​1001/​jamainternmed.​2014.​739 CrossRefPubMed
49.
Zurück zum Zitat Piepoli MF, Conraads V, Corra U et al (2011) Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail 13(4):347–357. doi:10.1093/eurjhf/hfr017 CrossRefPubMed Piepoli MF, Conraads V, Corra U et al (2011) Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail 13(4):347–357. doi:10.​1093/​eurjhf/​hfr017 CrossRefPubMed
50.
Zurück zum Zitat McAlister FA, Lawson FM, Teo KK (2001) A systematic review of randomized trials of disease management programs in heart failure. Am J Med 110(5):378–384CrossRefPubMed McAlister FA, Lawson FM, Teo KK (2001) A systematic review of randomized trials of disease management programs in heart failure. Am J Med 110(5):378–384CrossRefPubMed
51.
Zurück zum Zitat Angermann CE, Stork S, Gelbrich G et al (2012) Mode of action and effects of standardized collaborative disease management on mortality and morbidity in patients with systolic heart failure: The Interdisciplinary Network for Heart Failure (INH) study. Circ Heart Fail 5(1):25–35. doi:10.1161/CIRCHEARTFAILURE.111.962969 CrossRefPubMed Angermann CE, Stork S, Gelbrich G et al (2012) Mode of action and effects of standardized collaborative disease management on mortality and morbidity in patients with systolic heart failure: The Interdisciplinary Network for Heart Failure (INH) study. Circ Heart Fail 5(1):25–35. doi:10.​1161/​CIRCHEARTFAILURE​.​111.​962969 CrossRefPubMed
53.
Zurück zum Zitat Gunold H, Angermann CE (2015) Kognitive Dysfunktion, Depression und Angst bei Herzinsuffizienz. Aktuel Kardol 2015(4):379–386 Gunold H, Angermann CE (2015) Kognitive Dysfunktion, Depression und Angst bei Herzinsuffizienz. Aktuel Kardol 2015(4):379–386
54.
Zurück zum Zitat Glassman AH et al (2002) Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA 288:701–709CrossRefPubMed Glassman AH et al (2002) Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA 288:701–709CrossRefPubMed
55.
Zurück zum Zitat Berkman LF et al (2003) Effects of treating depression and low perceived social support on clinical events after myocardial infarction: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA 289:3106–3116CrossRefPubMed Berkman LF et al (2003) Effects of treating depression and low perceived social support on clinical events after myocardial infarction: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA 289:3106–3116CrossRefPubMed
56.
Zurück zum Zitat Lespérance F et al (2007) Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: The Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. JAMA 297:367–379CrossRefPubMed Lespérance F et al (2007) Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: The Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. JAMA 297:367–379CrossRefPubMed
57.
Zurück zum Zitat Van den Brink RH et al (2002) Treatment of depression after myocardial infarction and the effects on cardiac prognosis and quality of life: Rationale and outline of the Myocardial Infarction and Depression-Intervention Trial (MIND-IT). Am Heart J 144:219–225CrossRefPubMed Van den Brink RH et al (2002) Treatment of depression after myocardial infarction and the effects on cardiac prognosis and quality of life: Rationale and outline of the Myocardial Infarction and Depression-Intervention Trial (MIND-IT). Am Heart J 144:219–225CrossRefPubMed
Metadaten
Titel
Depression und Herzinsuffizienz – doppeltes Risiko?
Diagnostik, prognostische Bedeutung und Therapie einer unterschätzten Komorbidität
verfasst von
J. Wallenborn
Prof. Dr. med. C. E. Angermann
Publikationsdatum
17.10.2016
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 8/2016
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-016-4483-8

Weitere Artikel der Ausgabe 8/2016

Herz 8/2016 Zur Ausgabe