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Symptoms of depression may worsen heart failure

n-1beta (IL-1beta). Previous research by other scientists has shown that the three cytokines, which all cause inflammation, are elevated in patients with heart failure.

Indeed, all of the patients in the study had higher-than-normal levels of each cytokine. However, TNF-alpha was still markedly higher in patients who reported feeling depressed on a regular basis.

"We were surprised to find that this wasn't the case for the other two cytokines," Ferketich said. "That suggests that something about depression may trigger the production of TNF-alpha."

The researchers measured cytokine levels in picograms, or trillionths of a gram. Patients with scores of 10 or higher on the BDI had levels of TNF-alpha nearly twice that of patients with a score less than 10 (4.9 pg/ml vs. 2.7 pg/ml.)

Levels of the other two cytokines were similar for depressed and non-depressed patients: 5.9 pg/ml vs. 5.1 pg/ml for IL-6 and 4.4 pg/ml and 3.6 pg/ml for IL-1beta, respectively.

Other researchers estimate that anywhere from 24 to 42 percent of heart failure patients also suffer from depression.

"Depression clearly raises the levels of one cytokine, which plays a role in increasing inflammation," Ferketich said. "What we don't know for sure is if depression causes the inflammation which may lead to heart failure or if heart failure causes depression which accelerates inflammation."

A study at Duke University found that patients with major depression are twice as likely to die or to be re-admitted to the hospital a second time within 12 months.

"Patients with heart disease are prone to developing depression," Ferketich said. "Physicians need to pay more attention to this. But research still needs to be done to find out if treating patients with anti-depressants would help to actually slow the progression of heart disease."


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Contact: Amy Ferketich
Aferketich@sph.osu.edu
614-293-4387
Ohio State University
7-Sep-2005


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