Depressive Symptoms and 6-Year KCCQ Health Status in Chronic Heart Failure: Findings From the Cognition.Matters-HF Cohort.

Authors

Philipp Winkelmann, Stephanie Wissel, Vladimir Cejka, György Homola, Caroline Morbach, Roxanne Sell, Stefan Frantz, Alexandra Wuttke, Mirko Pham, Guido Stoll, Stefan Störk, Anna Frey, Jan Traub

Published in

JACC. Advances. Volume 5. Issue 12 Pt 2. Pages 103415. Oct 30, 2026. Epub Oct 30, 2026.

Abstract

Long-term disease-specific health status trajectories in ambulatory chronic heart failure (HF) are incompletely characterized, and the contribution of depressive symptoms remains uncertain.
The objectives of the study was to characterize 6-year Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS) trajectories and distinguish persistent and visit-specific depressive symptom associations with health status.
In the prospective Cognition.Matters-HF cohort, 148 patients with HF underwent assessments at baseline and 6, 12, 36, and 69 months. Linear mixed-effects models estimated KCCQ-OSS trajectories and prespecified correlates. Patient Health Questionnaire-9 (PHQ-9) scores were decomposed into between-person and within-person components. Sensitivity analyses addressed missingness, and exploratory lagged analyses assessed whether recent PHQ-9 worsening predicted subsequent KCCQ deterioration or adverse clinical events.
KCCQ-OSS remained stable over 69 months (78.0-76.6; change: -1.4; 95% CI: -4.6 to 1.8; P for time = 0.065), despite substantial individual variation. Higher between-person PHQ-9 burden (β: -3.44 per point; 95% CI: -4.00 to -2.88; P < 0.001) and within-person PHQ-9 worsening (β: -1.80; 95% CI: -2.50 to -1.11; P < 0.001) were associated with lower concurrent KCCQ-OSS. Recent PHQ-9 worsening did not predict subsequent KCCQ-OSS, a ≥5-point KCCQ decline, or all-cause death/HF hospitalization. NYHA functional class and 6-min walking distance, but not N-terminal pro-B-type natriuretic peptide, left ventricular ejection fraction, or executive function, were independently associated with KCCQ-OSS.
In ambulatory chronic HF, average KCCQ-based health status remained stable over 6 years despite substantial individual variation. Depressive symptoms were strongly associated with concurrent health status, but recent worsening did not predict subsequent KCCQ deterioration or adverse clinical events.

PMID:
42962434
Bibliographic data and abstract were imported from PubMed on 31 Oct 2026.

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