[Exercise test interpretation in patients with major depressive disorder; Are any specific considerations needed?]

ABSTRACT

Exercise test [ET] is the first line of ischemia assessment in patients with suspected Coronary Artery Disease [CAD]. We conducted this study to evaluate whether Major Depressive Disorder [MDD] influences the parameters of ET performance and affects the interpretation of test results. In an ex-post facto study, 265 patients [191 Men, 74 women; mean age 48 +/- 10 years, 22-75 years old] referred for ET were enrolled through convenient sampling after completing and signing informed consent forms. After exercise testing, Beck Depression Inventory [BDI] was used to assess depression. Data was analyzed using t- paired, k2 and correlation co-efficient tests under SPSS10 software. The prevalence of depression was 41.5%. The proportion of positive ET in depressed and non-depressed groups was 23.6% and 19.4% respectively [p > 0.05]. After adjustment for age, sex, family history of CAD, and smoking habit, total exercise duration showed negative correlation with BDI scores [p < 0.001]. Correlation analysis for Maximum Predicted Heart Rate showed a strong trend of negative relation [p = 0.06]. Duration of performing ET was significantly lower in MDD patients [p = 0.001]. Negative correlation of BDI with ET performing duration was true both before and after corrections for the mentioned variables [p = 0.001]. Decreased psychomotor activity in depression may lead to inadequate exercise duration and affect the performance indices. However, if the performance indices of ET in a depressed patient are acceptable, the test result could be interpreted with confidence