Article

Depression and reduced exercise capacity are risk factors for poor
prognosis in patients with heart disease, but the relationship between the 2 is
unclear. We assessed the relationship between depressive symptoms and exercise
capacity in patients with heart disease. METHODS: PubMed, Cochrane Library,
Google Scholar, and ProQuest databases were browsed for English-language studies
published from January 2000 to September 2013. Studies including adult patients
with coronary artery disease, heart failure, congenital heart disease, and
implantable cardioverter defibrillator, reporting correlation between a
depression scale and exercise capacity ((Equation is included in full-text
article.)O2peak, peak watts, estimated metabolic equivalents, and incremental
shuttle walk test distance), as well as studies from which such a correlation
could be calculated and provided by the authors, were included. Correlation
coefficients (CCs) were converted to Fischer z values, and the analysis was
performed using a random-effects model. Then, summary effects and 95% CIs were
converted back to CCs. RESULTS: Fifty-nine studies (25 733 participants) were
included. Depressive symptoms were inversely correlated to exercise capacity (CC
= -0.15; 95% CI, -0.17 to -0.12). Heterogeneity was significant (I = 64%; P <
.001). There was no evidence of publication bias (Fail-safe N = 4681; Egger test:
P = .06; Kendall test: P = .29). CONCLUSIONS: Patients with heart disease and
elevated depressive symptoms may tend to have reduced exercise capacity, and vice
versa. This finding has clinical and prognostic implications. It also encourages
research on the effects of improving depression on exercise capacity, and vice
versa. The effects of potential moderators need to be explored.

Langue : ANGLAIS