0000000000352477
AUTHOR
Jacqueline M. Smits
Depression and disease severity as correlates of everyday physical activity in heart transplant candidates
Summary It is unclear to what extent patients awaiting heart transplantation (HTx) engage in physical activities. We examined the everyday physical activity and its associations with depressive symptoms and disease severity in 318 patients newly registered for HTx in the multi-site study ‘Waiting for a New Heart’ (aged 53.5 ± 11.4 years, 18% female patients). Participants completed questionnaires assessing depressive symptomatology and physical activity (number of physical activities, caloric expenditure associated with each activity), and estimated the distance they were able to walk without a break. Medical parameters at the time of listing [e.g. peak oxygen consumption (peakVO2); the Ger…
Composite risk scores and depression as predictors of competing waiting-list outcomes: the Waiting for a New Heart Study
We evaluated two composite risk scores, (Heart Failure Survival Score, HFSS; German Transplant Society Score, GTSS), and depression as predictors of mortality and competing waiting-list outcomes [high-urgency transplantation (HU-HTx), elective transplantation, delisting because of clinical improvement] in 318 heart transplant (HTx) candidates (18% women; aged 53 ± 11 years) from 17 hospitals and newly registered with Eurotransplant. Demographic variables and depression (Hospital Anxiety and Depression Scale, HADS) were assessed using questionnaires. Variables to compute HFSS and GTSS, age, medications, and outcomes were provided by Eurotransplant. At 12 months, 33 patients died, 83 received…
Psychological Characteristics and Social Integration of Patients with Ischemic and Non-Ischemic Heart Failure Newly Listed for Heart Transplantation: The Waiting for a New Heart Study
It is not known whether psychosocial risk factors for coronary artery disease (CAD) are present in patients listed for heart transplantation (HTx). The aim of this study was to examine whether HTx candidates with ischemic heart failure (due to CAD) have an adverse psychological risk profile and reduced social integration compared to patients with non-ischemic etiology. In the multi-site study "Waiting for a New Heart", waiting-list-related stressors, depression, anxiety, trait-anger, anger-expression, dispositional coping, social integration, and social support were assessed in 318 newly registered HTx candidates (53.5 ± 11.4 years, 18% female, left ventricular ejection fraction <25%). Medi…
Psychosocial and behavioural factors in heart transplant candidates--an overview.
Mortality among heart transplant (HTX) candidates remains high. This review of the literature shows that psychosocial characteristics like depression, social isolation and coping strategies contribute to morbidity and mortality in heart failure (HF) patients, and may also be relevant to the prognosis of HTX candidates. Based on the research to date, physical activity favourably affects subjective and objective parameters not only in HF patients, but also in HTX candidates. Depression is prevalent among HTX candidates, especially in ischaemic patients, and seems to be related to earlier transplantation. Findings on the effects of depression on pretransplant mortality are conflicting. Not muc…
Social isolation and depression predict 12-month outcomes in the "waiting for a new heart study".
Identification of modifiable psychosocial characteristics related to survival of heart transplant (HTx) candidates is needed to prevent clinical deterioration and improve prognosis.A multi-site, prospective study was conducted with 318 HTx candidates (18% female, 82% male; 53 +/- 11 years of age) newly listed at 17 hospitals in Germany and Austria. Baseline demographic and psychosocial characteristics were assessed by questionnaires. Indicators of disease severity (Heart Failure Survival Score, creatinine, cardiac index) and 12-month outcomes (death, high-urgency HTx, elective HTx, de-listing due to deterioration or improvement) were provided by Eurotransplant.By 12 months, 33 patients died…
Prognosis of Patients Listed for a Heart Transplant During the Pretransplant Period: Does Diabetes Matter?
Whether patients with advanced heart failure and diabetes mellitus (DM) should be listed for heart transplantation (HTx) remains controversial due to conflicting findings regarding their post-HTx survival (1–3). We studied HTx candidates with and without DM during the pre-HTx period, examining multiple waiting list outcomes. Patients were enrolled in the Waiting for a New Heart Study, a multisite observational study of 318 adult (≥18 years of age) patients (aged 53 ± 11 years; 18% female) who were newly listed for HTx with Eurotransplant between April 2005 and December 2006 (4). Informed consent and ethics approval were obtained (4). Characteristics at the time of listing included age, DM, …
Dietary habits are related to outcomes in patients with advanced heart failure awaiting heart transplantation.
Abstract Background Empirical evidence supporting the benefits of dietary recommendations for patients with advanced heart failure is scarce. We prospectively evaluated the relation of dietary habits to pre-transplant clinical outcomes in the multisite observational Waiting for a New Heart Study. Methods and Results A total of 318 heart transplant candidates (82% male, age 53 ± 11 years) completed a Food Frequency Questionnaire (foods high in salt, saturated fats, poly-/monounsaturated fats [PUFA+MUFA], fruit/vegetables/legumes, and fluid intake) at time of waitlisting. Cox proportional hazard models controlling for heart failure severity (eg, Heart Failure Survival Score, creatinine) estim…
Patients' sex and emotional support as predictors of death and clinical deterioration in the Waiting for a New Heart Study: results from the 1-year follow-up
Context—Little is known about the role of patient's sex and emotional support in the prognosis of heart transplant candidates.Objective—To examine patient's sex and emotional support as predictors of outcomes in the Waiting for a New Heart Study.Design, Setting, and Participants—The Waiting for a New Heart Study is a prospective observational study of 318 patients (18% female) newly added to the waiting list for a heart transplant. Demographic, medical, psychosocial characteristics (including social support [ENRICHD Social Support Index; high vs low support]) were assessed at the time of wait-listing.Main Outcomes—Time until death/delisting due to deteriorated health, considering competing …