Effect of Short-Term Psychological Intervention on Depression Dynamics in Aortic Stenosis Patients Undergoing Transcatheter Aortic Valve Implantation.

OBJECTIVE

Because depression has been identified as a relevant comorbidity in cardiovascular patients, we aimed to assess the impact of a brief expectation-focused psychological intervention on depression dynamics in aortic stenosis patients undergoing transcatheter aortic valve implantation (TAVI).

METHODS

From 82 TAVI patients showing a Hospital Anxiety and Depression Scale (HADS-D) score ≥8 points for depression, 74 patients underwent 1:1 randomization, with 38 assigned to the control (CON; treatment as usual) and 36 to the intervention (INT; psychological short-term intervention) group. The psychological intervention consisted of 2 individual sessions before and 2 booster sessions after TAVI. Per protocol, the HADS-D score for depression at 6 months was defined as the primary outcome and compared with baseline between the CON and the INT group by using analysis of covariance (ANCOVA).

RESULTS

Regarding the primary outcome measure, there was a mean HADS-D depression score of 10.76 (SD: 2.77) at baseline and 9.44 (SD: 4.56) at 6 months after TAVI in the CON group and of 9.86 (SD: 2.0) at baseline and 7.5 (SD: 3.15) at 6 months after TAVI in the INT group. ANCOVA did not show a significant effect of the psychological short-term interventions versus control (estimate=-1.67; 95% CI=-3.64 to -0.29) on depression dynamics 6 months after TAVI, adjusted for baseline HADS-D.

CONCLUSIONS

An effect of a psychological intervention on depression dynamics could not be shown. However, there was an improvement in depression at 6 months after TAVI, which is probably due to a decline in heart failure symptoms.