Diastolic Heart Failure Clinical Trial
Official title:
Prognostic Value of Negative Affectivity in Patients With Heart Failure
This prospective observational study is designed to confirm the prognostic and economic impact of depression in ambulatory patients with systolic or diastolic heart failure, to explore the impact of other psychosocial patterns such as type D personality, anxiety disorders, locus of control, perceived social support, anger, hopelessness, and to evaluate potential pathophysiological and behavioral pathways.
Studies suggest that depressive symptoms may be associated with a worse prognosis and higher
costs of care in patients with chronic heart failure in some populations, but such data in a
French population are missing. On the other hand, little is known of the impact of other
psychosocial dysfunction whereas the pathophysiology of this association remains
hypothetical.
Main objective: to confirm the impact of depressive symptoms on cardiovascular death in
ambulatory heart failure patients
Other objectives:
- to study the impact of depressive symptoms on sudden death, non cardiovascular death,
and hospitalization rates;
- to study the role of other psychosocial patterns or personality traits such as anxiety
disorders, locus of control, perceived social support, anger, hopelessness, optimism
and type D personality in cardiovascular and total mortality;
- to study the interaction with patient behaviors (drug compliance, addictions);
- to explore some pathophysiological pathways (chronic inflammation and chronic loss of
myocytes),
- and to evaluate the impact of psychosocial distress on health care costs. Design:
multicenter observational study with a minimum of 2 year follow up Population: 700
ambulatory patients, aged above 18 y.o., with acute heart failure within the last 24
months
Methodology:
- psychosocial patterns and personality traits are assessed using validated
self-administered questionnaire; use of the Beck Depression Index in this population is
validated against the Montgomery & Asberg Depression Rating Scale evaluation
- cardiac condition is evaluated at pre-defined time period by B-natriuretic peptide
levels, echocardiography and 6'-walk test
End-point criteria:
- primary : rate of cardiovascular death
- secondary : rate of total mortality and sudden death, rate of rehospitalization for
heart failure and for any cause, total and specific health care costs.
;
Observational Model: Cohort, Time Perspective: Prospective
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