Sex differences in the association between N-terminal pro B-Type natriureticpeptide (NT-proBNP) and anxiety in patients with heart failure and preserved ejection fraction

• Published in: Journal of psychosomatic research 2019-06, Vol.121, p.115-115
• Main Authors: Herrmann-Lingen, Christoph, Nolte, Kathleen, Hasenfuß, Gerd, Wachter, Rolf, Edelmann, Frank
• Format: Article
• Language: English
• Subjects: Anxiety; Anxiolytics; Congestive heart failure; Ejection fraction; Gender differences; Heart failure; Mental depression; Patients; Physical ability; Severity; Sex differences; Women
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2019.03.049

Aim: Natriuretic peptides are established severity markers for heart failure. However, previous research suggests that they may have an anxiolytic-like effect. We used data from the Aldo-DHF trial of spironolactone for heart failure with preserved ejection fraction (HFpEF) to test whether a) the inverse association of NT-proBNP with anxiety can be confirmed in heart failure patients, both men and women, and b) baseline NT-proBNP also predicts future anxiety. Methods: We correlated baseline NT-proBNP with Hospital Anxiety and Depression Scale anxiety (HADS-A) scores at baseline and 12 months. Multivariate regression was performed with HADS-A as dependent and baseline NT-proBNP as predictor, controlling for physical function and treatment assignment. Baseline HADS-A and NTproBNP were available for 178 men and 195 women (67.0 ± 7.5 years old). Results: Baseline NT-proBNP was significantly related to reduced physical function (rho = -0.122; p = .022) but inversely correlated with baseline HADS-A at trend level (rho = -0.096; p = .065). Anxiety and physical function were interrelated (rho = -0.244; p< .001). Controlling for physical function, the negative association between NT-proBNP and HADSA became almost significant (rho = -0.101; p = .051). Regardless of treatment assignment, log(NT-proBNP) significantly predicted lower HADS-A at baseline (beta = -0.176; p = .014) and 12 months (beta =-0.160; p = .035) in men but not in women. Conclusion: Higher NT-proBNP indicates more severe disease but is related to lower anxiety in patients with HFpEF. This effect is limited to men, in whom baseline NT-proBNP independently predicts anxiety even one year later.