Article

Heart Failure Reviews

, Volume 14, Issue 1, pp 35-50

First online:

Psychobiology of depression/distress in congestive heart failure

  • Kaki M. YorkAffiliated withVAMC, Psychology Service (116b), North Florida/South Georgia VA Healthcare System Email author 
  • , Mustafa HassanAffiliated withVAMC, Cardiology Research, North Florida/South Georgia VA Healthcare SystemCardiovascular Research, Department of Medicine, The University of Florida
  • , David S. ShepsAffiliated withVAMC, Cardiology Research, North Florida/South Georgia VA Healthcare SystemCardiovascular Research, Department of Medicine, The University of Florida

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Abstract

Heart failure affects millions of Americans and new diagnosis rates are expected to almost triple over the next 30 years as our population ages. Affective disorders including clinical depression and anxiety are common in patients with congestive heart failure. Furthermore, the presence of these disorders significantly impacts quality of life, medical outcomes, and healthcare service utilization. In recent years, the literature has attempted to describe potential pathophysiologic mechanisms relating affective disorders and psychosocial stress to heart failure. Several potential mechanisms have been proposed including autonomic nervous system dysfunction, inflammation, cardiac arrhythmias, and altered platelet function. These mechanisms are reviewed in this article. Additional novel mechanisms such as mental stress-induced myocardial ischemia are also discussed.

Keywords

Heart Failure Depression Mental stress Mechanisms