Effects of Sertraline on Circulating Markers of Oxidative Stress in Depressed Patients With Chronic Heart Failure: A Pilot Study

• Published in: Journal of cardiac failure 2011-09, Vol.17 (9), p.748-754
• Main Authors: Michalakeas, Christos A., MD, Parissis, John T., MD, Douzenis, Athanasios, MD, Nikolaou, Maria, MD, Varounis, Christos, MD, Andreadou, Ioanna, PhD, Antonellos, Nikolaos, MS, Markantonis-Kiroudis, Sophia, PhD, Paraskevaidis, Ioannis, MD, Ikonomidis, Ignatios, MD, Lykouras, Evaggelos, MD, Kremastinos, Dimitrios, MD
• Format: Article
• Language: English
• Subjects: Aged; BDI; Biomarkers - blood; Cardiovascular; chronic heart failure; Cohort Studies; Depression; Depression - blood; Depression - drug therapy; Depression - psychology; Female; Heart Failure - blood; Heart Failure - drug therapy; Heart Failure - psychology; Humans; Male; Malondialdehyde - blood; Middle Aged; nitrosative stress; oxidative stress; Oxidative Stress - drug effects; Oxidative Stress - physiology; Pilot Projects; selective serotonin reuptake inhibitors; Serotonin Uptake Inhibitors - pharmacology; Serotonin Uptake Inhibitors - therapeutic use; Sertraline - pharmacology; Sertraline - therapeutic use; Zung SDS
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2011.05.004

Abstract Background Depression is a common comorbid condition in patients with chronic heart failure (CHF). This pilot study investigated the plasma levels of oxidative stress markers in depressed CHF patients as well as the effects of antidepressant treatment with sertraline on these markers in the same patient population. Methods and Results Patients with positive depression screening [Beck Depression Inventory (BDI) score >10 and/or Zung Self-Rating Depression Scale >40] underwent a psychiatric interview. Patients newly diagnosed as depressed received pharmacologic treatment with sertraline for 3 months (arm A) and were compared with those who did not comply with the antidepressant treatment (arm B). Markers of oxidative stress [malondialdehyde (MDA) and protein carbonyls (PC)], and nitrosative stress [nitrotyrosine (NT)] were assessed at baseline and 3 months later. Fifty-two out of 254 screened hospitalized CHF patients were diagnosed as depressed. Depressed patients had significantly higher levels of MDA compared with age- and gender-matched nondepressed patients (n = 40; 3.2 ± 2.0 vs 2.8 ± 3.8 μmol/L; P  = .02). Twenty-eight patients received sertraline (arm A), and 24 refused to receive antidepressant treatment on the top of optimal heart failure treatment (arm B). Although baseline levels of MDA and PC in arm A and arm B did not differ significantly ( P > .05), arm A patients demonstrated a significant reduction in MDA (F = 4.657; P  = .037) and arm B patients demonstrated no change after 3 months. Regarding the examined scores, arm A patients had a decrease in BDI score (28 ± 11 vs 21 ± 13; P  = .008), and arm B patients had no change in BDI score at follow-up ( P > .05). Arm A had an increase in 6-minute walking distance (291 ± 110 vs 361 ± 87 m; P  = .02), and arm B experienced no change ( P > .05). Conclusions Increased oxidative stress may play a critical role in the pathophysiology of depression in CHF. Treatment with sertraline improves depressive symptoms and reduces plasma markers of oxidative stress in depressed CHF patients.