Abstract 14769: Bypassing Troubles: Relation of Exhaustion, Viral Burden, and Inflammation to Depressive Symptoms After Cardiac Surgery
Background: Inflammation is a mechanism by which depressive symptoms and vital exhaustion (VE) may confer increased risk of adverse cardiac outcomes. Objective: To elucidate the relationship of post- bypass (CABG) depressive symptoms to VE, immune-mediated inflammation and pathogen burden (PB), defined as cumulative seropositive exposure to infectious pathogens.
Methods: In a secondary analysis of 42 patients (age 67.5 ± 12.6 years, 90.5% male, 66.7% Caucasian, nonsmokers, and without malignancy, autoimmune disease or infection), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), VE (Maastricht Interview), CBC and lipids were assessed before and 4-8 weeks after CABG. Immune markers (interleukin [IL]-6, IL-10, soluble intercellular adhesion molecule-1) and serum IgG antibodies (Herpes Simplex Virus-1 and -2, Cytomegalovirus, Epstein Barr Virus) were measured by ELISA. PB was defined as low (0-1 exposures), moderate (2-3 exposures) and high (4 exposures). Analyses included Mann-Whitney U test and logistic regression.
Results: Prevalence of none and mild-moderate depressive symptoms was 85.7% and 14.3%, respectively. PHQ-9 scores were correlated with preop monocytes (rho = 0.393, p = 0.035), ejection fraction (rho = 0.329, p = 0.033) and VE scores (rho = 0.627, p < 0.001). Compared to patients without symptoms, patients with mild-moderate symptoms had higher scores for preop monocytes (p = 0.03) and triglycerides (p = 0.048) and for postop lymphocytes (p = 0.01) and VE scores (p = 0.002). Immune markers and PB were not associated with depressive symptoms. Patients with mild-moderate symptoms were more likely to have higher VE scores and tended toward elevated preop leukocytes (Table).
Conclusion: After CABG, depressive symptoms are associated with VE, triglycerides, monocytes, and lymphocytes. These findings reveal a viable lipid-immune pathway linking depressive symptoms to adverse cardiac outcomes.
- © 2011 by American Heart Association, Inc.