Over the past two decades, there has been an increased interest to study the relationship between depression and heart failure (HF) stemming from the fact that HF is the fastest growing entity of cardiovascular disease affecting 26 million patients worldwide and responsible for 1 million hospitalizations per year in the United States [1], in addition to the high rates of depression reported among HF population in multiple studies [2]. The high morbidity and mortality in HF and the accompanying enormous healthcare costs stimulate research looking for predictors of poor performance and outcomes.