Learning Objective #1: Identify the relationships among depression, cytokines and heart failure

Learning Objective #2: Appreciate the effect of serum biomarkers on patients' outcomes

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Heart failure (HF) is a chronic clinical syndrome, resulting from many disorders that interfere with cardiac function. It may be coupled with clinically relevant psychological impairments such as depression, anxiety, and anger. The American Heart Association (2002) has estimated that more than 4,900,000 American currently have HF. Moreover, HF and depression are associated with many immunologic and functional changes that evolve at different physiologic and anatomic levels. Numerous studies have shown that HF is associated with elevated plasma levels of pro-inflammatory cytokines IL-6, TNF-alpha which increases as NYHA heart failure functional class worsens. Also, the recent research shows that clinically depressed patients have elevated levels of pro-inflammatory risk markers that have been implicated in HF pathogenesis. However, the relationship between depressive symptoms and pro-inflammatory cytokines levels in HF patients has not been studied yet. Therefore, a correlational descriptive study of a convenience sample of 100 adults with HF, ages 21 and older, will be used to examine the relationship between pro-inflammatory cytokines and depressive symptoms. The plasma levels of the pro-inflammatory cytokines IL-6, TNF-alpha will be measured by using commercially available immunoassay kits which utilize the quantitative sandwich enzyme immunoassay technique. The Center for Epidemiologic Studies Depression Scale is a measure of depressive symptoms and mood status rather than of clinical depression will be used in this study. Pearson correlation Coefficient will be used to examine the strength of the relationship between circulating cytokine levels and depressive symptoms in HF patients. A regression analysis will be performed to establish the predictive value of cytokine levels, gender, BMI and age in determining severity of depressive symptoms. This study will enhance our understanding about the relationship between serum biomarkers and depressive symptoms in HF patients. It will also stimulate further research and assist in developing appropriate interventions for improving HF patients' outcomes.