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Relationship between depression and subclinical left ventricular changes in the general population
  1. Yong-Hyun Kim1,
  2. Seong Hwan Kim1,
  3. Sang Yup Lim1,
  4. Goo-Yeong Cho2,
  5. In-Kyung Baik3,
  6. Hong-Euy Lim4,
  7. Jin Oh Na4,
  8. Seong Woo Han4,
  9. Young-Hoon Ko5,
  10. Chol Shin6
  1. 1Division of Cardiology, Department of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
  2. 2Division of Cardiology, Department of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  3. 3Department of Foods and Nutrition, Kookmin University, Seoul, Republic of Korea
  4. 4Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
  5. 5Department of Psychiatry, Korea University Ansan Hospital, Ansan, Republic of Korea
  6. 6Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Republic of Korea
  1. Correspondence to Dr Seong Hwan Kim, Division of Cardiology, Department of Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 516 Gojan-1-dong, Danwon-gu, Ansan-si, Gyeonggi-do 425-707, Korea; cardioguy{at}korea.ac.kr

Abstract

Objective Individuals with depression are at risk of heart failure. This study was designed to elucidate the relationship between depression and subclinical left ventricular (LV) changes in the general Korean population.

Design Cross-sectional cohort study.

Setting University hospital.

Patients A total of 2420 participants, aged 40–79 years, without known cardiovascular disease, were recruited from the Korean Genome Epidemiology Study.

Methods All individuals underwent conventional two-dimensional echocardiography and tissue Doppler imaging (TDI) to measure LV changes. In addition, subjects answered the Beck depression inventory I (BDI-I) questionnaire to assess depression levels. Participants were assigned to one of three groups based on the BDI-I score: no depression (0≤ BDI-I <10), mild depression (10≤ BDI-I <20), and moderate to severe depression (BDI-I ≥20).

Results LV diastolic function parameters, such as the transmitral A wave velocity and E/A ratio, TDI early diastolic velocity (Ea), and E/Ea ratio, were progressively altered across the levels of depression (all p<0.01). After multivariate adjustment, subjects with moderate to severe depression showed a significantly higher LV mass index (p=0.019) and lower TDI Ea velocity (p=0.006) compared with those without depression. In linear regression models, the presence of depression (BDI-I ≥10) was independently associated with a lower TDI Ea velocity (p=0.004).

Conclusions Individuals with moderate to severe depression showed subclinical alterations in LV structure and function. These findings support the hypothesis that clinical depression may be an independent risk factor for the development of cardiovascular disease.

  • Depression
  • diastole
  • echocardiography
  • left ventricle
  • tissue Doppler imaging
  • cardiac function
  • hypertension
  • metabolic medicine
  • metabolic syndrome
  • imaging and diagnostics
  • allied specialities

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Footnotes

  • Funding This study was supported by grants (2009-E00454-00 and 2010-E71001-00) from the Korean Centers for Disease Control and Prevention.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was approved by the Human Subjects Review Committee at the Korea University Ansan Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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