Figure 3. Changes in depression and anxiety in response to LVAD by implant strategy.

Changes in depression (A; as measured by the patient health questionnaire) and anxiety (B; as measured by the brief symptom inventory) are depicted comparing pre-operative assessment with measure taken at 1, 3 and 6 months after LVAD; the mean and 95% confidence interval is represented by column height and the high and low whisker bars, respectively. Solid lines and lighter bar graphs represent bridge therapy patients, and dashed lines and darker bars represent destination therapy patients. Two phases of change in symptoms are depicted; the initial response to LVAD between pre-implant and 1 month post-implant (Δ₁), and the subsequent change between 1 and 6 months post-implant (Δ₂). The effect size of each phase of change is also presented as Cohen’s d (d) (0.2–0.3 = small, ≈ 0.5 = moderate, and ≥ 0.8 = large effect). The difference (diff) and significance thereof (sig) of symptoms pre-implant and during each phase of change between destination and bridge therapy patients are presented below the figure.

Abbreviations: BSI = Brief Symptom Inventory; BT = bridge therapy; Diff. = difference; DT = destination therapy; PHQ9 = patient health questionnaire; LVAD = left ventricular assist device; Sig. = significance; t = t-test.