PDF(Pubmed)
Abstract：
UNASSIGNED: Improved long-term survival has widened the treatment goals for adults with congenital heart disease (ACHD) by addressing parameters that impact mental well-being and exercise capacity. Depression, a frequent co-morbidity in ACHD, is linked to both. Whether successful treatment of depression also affects cardiac parameters is a matter of debate.
UNASSIGNED: This prospective, cross-sectional, longitudinal study included N = 150 ACHD (mean age 35.2 ± 11.3 years, 57% male) at baseline (t0) and N = 114 at follow-up (mean follow-up: 4.8 ± 0.6 years; t1). Patients were interviewed using a structured clinical interview, and severity of depression was assessed using the Montgomery-Asperg Depression Scale (MADRS). Additional testing was performed using self-rating questionnaires concerning depression, anxiety and quality of life (QoL). Exercise capacity (VO2max) was assessed by symptom limited exercise testing.
UNASSIGNED: Of N = 33 patients diagnosed with depression at t0, N = 18 patients remitted and N = 15 were non-remitters. Remitters displayed significantly decreased anxiety (P = 0.013), improved global QoL (P = 0.002), and preserved VO2max (P = 0.958) at t1 compared to t0. This was associated with favourable health behaviour at t1 and stable body-mass-index. Contrarily, non-remitters reported further increased anxiety (P = 0.021) and no significant improvement in QoL (P = 0.405). VO2max declined significantly (P = 0.006) and body-mass-index increased (P = 0.004). Never-depressed patients showed no significant changes in anxiety (P = 0.415) or QoL (P = 0.211). VO2max decreased significantly (P < 0.001).
UNASSIGNED: In ACHD, remission from depression is associated with better physical functioning, mental health, and QoL. The assessment and treatment of depression in ACHD emerges as an important clinical goal that should be included in a comprehensive multimodal treatment plan.
UNASSIGNED: This prospective, cross-sectional, longitudinal study included N = 150 ACHD (mean age 35.2 ± 11.3 years, 57% male) at baseline (t0) and N = 114 at follow-up (mean follow-up: 4.8 ± 0.6 years; t1). Patients were interviewed using a structured clinical interview, and severity of depression was assessed using the Montgomery-Asperg Depression Scale (MADRS). Additional testing was performed using self-rating questionnaires concerning depression, anxiety and quality of life (QoL). Exercise capacity (VO2max) was assessed by symptom limited exercise testing.
UNASSIGNED: Of N = 33 patients diagnosed with depression at t0, N = 18 patients remitted and N = 15 were non-remitters. Remitters displayed significantly decreased anxiety (P = 0.013), improved global QoL (P = 0.002), and preserved VO2max (P = 0.958) at t1 compared to t0. This was associated with favourable health behaviour at t1 and stable body-mass-index. Contrarily, non-remitters reported further increased anxiety (P = 0.021) and no significant improvement in QoL (P = 0.405). VO2max declined significantly (P = 0.006) and body-mass-index increased (P = 0.004). Never-depressed patients showed no significant changes in anxiety (P = 0.415) or QoL (P = 0.211). VO2max decreased significantly (P < 0.001).
UNASSIGNED: In ACHD, remission from depression is associated with better physical functioning, mental health, and QoL. The assessment and treatment of depression in ACHD emerges as an important clinical goal that should be included in a comprehensive multimodal treatment plan.
摘要：
■通过解决影响心理健康和运动能力的参数，长期生存率的提高扩大了先天性心脏病（ACHD）成人的治疗目标。抑郁症,ACHD的常见合并症，两者都有联系。抑郁症的成功治疗是否也会影响心脏参数是一个有争议的问题。
■这个前景，横截面,纵向研究包括N=150ACHD(平均年龄35.2±11.3岁，57％的男性）在基线（t0）和随访时N=114（平均随访：4.8±0.6年；t1）。使用结构化临床访谈对患者进行了访谈，使用Montgomery-Asperg抑郁量表（MADRS）评估抑郁的严重程度。使用关于抑郁症的自我评估问卷进行了额外的测试，焦虑和生活质量(QoL)。通过症状受限运动测试评估运动能力（VO2max）。
■在t0时诊断为抑郁症的N=33例患者中，N=18例患者缓解，N=15例非缓解者。重复者显示焦虑显著降低(P=0.013),改善的全局QoL(P=0.002)，与t0相比，在t1保留了VO2max（P=0.958）。这与t1时良好的健康行为和稳定的体重指数有关。相反，非缓解者报告焦虑进一步增加(P=0.021),QoL无显著改善(P=0.405).VO2max显著下降(P=0.006),体质量指数增加(P=0.004)。从未抑郁的患者在焦虑（P=0.415）或QoL（P=0.211）方面没有显着变化。VO2max显著降低(P<0.001)。
■在ACHD中，抑郁症的缓解与更好的身体功能有关，心理健康,和QoL。ACHD中抑郁症的评估和治疗已成为重要的临床目标，应纳入综合的多模式治疗计划。
■这个前景，横截面,纵向研究包括N=150ACHD(平均年龄35.2±11.3岁，57％的男性）在基线（t0）和随访时N=114（平均随访：4.8±0.6年；t1）。使用结构化临床访谈对患者进行了访谈，使用Montgomery-Asperg抑郁量表（MADRS）评估抑郁的严重程度。使用关于抑郁症的自我评估问卷进行了额外的测试，焦虑和生活质量(QoL)。通过症状受限运动测试评估运动能力（VO2max）。
■在t0时诊断为抑郁症的N=33例患者中，N=18例患者缓解，N=15例非缓解者。重复者显示焦虑显著降低(P=0.013),改善的全局QoL(P=0.002)，与t0相比，在t1保留了VO2max（P=0.958）。这与t1时良好的健康行为和稳定的体重指数有关。相反，非缓解者报告焦虑进一步增加(P=0.021),QoL无显著改善(P=0.405).VO2max显著下降(P=0.006),体质量指数增加(P=0.004)。从未抑郁的患者在焦虑（P=0.415）或QoL（P=0.211）方面没有显着变化。VO2max显著降低(P<0.001)。
■在ACHD中，抑郁症的缓解与更好的身体功能有关，心理健康,和QoL。ACHD中抑郁症的评估和治疗已成为重要的临床目标，应纳入综合的多模式治疗计划。
