Depression and anxiety in elderly patients with severe symptomatic aortic stenosis persistently improves after transcatheter aortic valve replacement (TAVR).

Introduction: Data on the prevalence of depression and anxiety in elderly cardiovascular disease patients are limited and there are only few studies focussing on treatment effects. Thus, the current study aimed to analyse elderly patients suffering from aortic stenosis (AS) and undergoing transcatheter aortic valve replacement (TAVR) with respect to both, prevalence rates before TAVR and dynamics in the clinical course.

Methods: The study included 140 AS patients undergoing TAVR (77.8 ± 7.7 years, 42.9% male, mean STS-Score 4.4 ± 2.2). Detailed clinical, laboratory and functional analysis was performed. In addition, quality of life (EQ-5D, EQ VAS), clinical frailty (CFS) and anxiety/depression (HADS-D), was assessed at baseline, 6 weeks, 6 months and 12 months after TAVR.

Results: Before TAVR, HADS-D revealed ≥8 points for anxiety and/or depression in 54 patients (38.6%), depression in 33 patients (23.6%) and for anxiety in 40 patients (28.6%). In the group showing HADS-D ≥8 points for anxiety, there was an improvement already 6 weeks after TAVR for anxiety (p < 0.05) but not for depression. In the group showing HADS-D ≥8 points for depression, there was a significant improvement at the 6 weeks' follow-up for both, depression (p < 0.001) and anxiety (p = 0.012) remaining stable for depression but not for anxiety until 12 months after TAVR.

Conclusions: TAVR leads to reductions of depression and anxiety in patients showing pathologic baseline values in HADS-D. There were no associations between pre-existing depression and anxiety with long-term mortality in our study.