Physical and psychological symptom biomechanics in moderate to advanced heart failure

J Cardiovasc Nurs. 2015 Jul-Aug;30(4):346-50. doi: 10.1097/JCN.0000000000000171.

Abstract

Background: There is a common dissociation between objective measures and patient symptomatology in heart failure (HF).

Objective: The aim of this study was to explore the relationship between cardiac biomechanics and physical and psychological symptoms in adults with moderate to advanced HF.

Methods: We performed a secondary analysis of data from 2 studies of symptoms among adults with HF. Stepwise regression modeling was performed to examine the influence of cardiac biomechanics (left ventricular internal diastolic diameter, right atrial pressure [RAP], and cardiac index) on symptoms.

Results: The average age of the sample (n = 273) was 57 ± 16 years, 61% were men, and 61% had class III or IV HF. Left ventricular internal diastolic diameter (β = 4.22 ± 1.63, P = .011), RAP (β = 0.71 ± 0.28, P = .013), and cardiac index (β = 7.11 ± 3.19, P = .028) were significantly associated with physical symptoms. Left ventricular internal diastolic diameter (β = 0.10 ± 0.05, P = .038) and RAP (β = 0.03 ± 0.01, P = .039) were significantly associated with anxiety. There were no significant biomechanical determinants of depression.

Conclusion: Cardiac biomechanics were related to physical symptoms and anxiety, providing preliminary evidence of the biological underpinnings of symptomatology among adults with HF.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomechanical Phenomena
  • Cross-Sectional Studies
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / physiopathology*
  • Heart Failure / psychology*
  • Humans
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Symptom Assessment