Symptoms in heart failure correlate poorly with objective haemodynamic parameters

Guglin, Maya; Patel, Toralben; Darbinyan, Nellie

doi:10.1111/j.1742-1241.2012.03003.x

Cited by 26 publications

(40 citation statements)

References 11 publications

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“…This finding was unexpected but is consistent with Leidy 14 who suggests that functional capacity is more closely related to age and comorbidities, rather than a single condition or disease process. These results are also consistent with previous finding that symptoms and hemodynamic parameters are poorly correlated 53 …”

Section: Discussionsupporting

confidence: 93%

The relationship between pain, fatigue, depression and functional performance in stable heart failure

2015

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Section: Discussionsupporting

confidence: 93%

The relationship between pain, fatigue, depression and functional performance in stable heart failure

2015

View full text Add to dashboard Cite

“…peak oxygen uptake). Finally, Guglin 20 recently concluded that there was no association between HF symptoms and multiple clinical factors that predict morbidity and mortality, including peak oxygen uptake, LVEF, Nt-proBNP, right heart catheterization parameters, and echocardiographic parameters. Our approach was different from prior research in that our goal was to identify distinct and common profiles among integrated data on symptoms and hemodynamics.…”

Section: Discussionmentioning

confidence: 99%

“…those derived from right heart catheterization, echocardiographic, cardiopulmonary stress test and laboratory parameters) and symptoms have collectively concluded that there is limited-to-no association between the two. 15–20 In the absence of a single test for HF or responsiveness to HF therapies, clinicians must integrate objective and subjective data to personalize treatment strategies. 21 For example, integrating data on current heart function and physical symptoms may allow clinicians to tailor monitoring strategies and/or promote effective self-care behaviors to enhance the patient’s quality of life and reduce healthcare utilization.…”

Section: Introductionmentioning

confidence: 99%

Symptom-Hemodynamic Mismatch and Heart Failure Event Risk

Lee

Hiatt

Denfeld

et al. 2015

Journal of Cardiovascular Nursing

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Background Heart failure (HF) is a heterogeneous condition of both symptoms and hemodynamics. Objective The goal of this study was to identify distinct profiles among integrated data on physical and psychological symptoms and hemodynamics, and quantify differences in 180-day event-risk among observed profiles. Methods A secondary analysis of data collected during two prospective cohort studies by a single group of investigators was performed. Latent class mixture modeling was used to identify distinct symptom-hemodynamic profiles. Cox proportional hazards modeling was used to quantify difference in event-risk (HF emergency visit, hospitalization or death) among profiles. Results The mean age (n=291) was 57±13 years, 38% were female, and 61% had class III/IV HF. Three distinct symptom-hemodynamic profiles were identified. 17.9% of patients had concordant symptoms and hemodynamics (i.e. moderate physical and psychological symptoms matched the comparatively hemodynamic profile), 17.9% had severe symptoms and average hemodynamics, and 64.2% had poor hemodynamics and mild symptoms. Compared to those in the concordant profile, both profiles of symptom-hemodynamic mismatch were associated with a markedly increased event-risk (severe symptoms hazards ratio = 3.38, p=0.033; poor hemodynamics hazards ratio = 3.48, p=0.016). Conclusions A minority of adults with HF have concordant symptoms and hemodynamics. Either profile of symptom-hemodynamic mismatch in HF is associated with a greater risk of healthcare utilization for HF or death.

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“…1 There is a limited association, however, between what patients experience as physical symptoms and what we can measure objectively about the severity of HF, including metrics of pressure, flow, contractility, exercise capacity and heart chamber geometry. 2–7 Most of what we know about HF in general, and about the relationship between objective measures of heart function and symptoms in particular, is derived from studies predominated by men. There are, however, several important gender differences in HF.…”

Section: Introductionmentioning

confidence: 99%

Gender-Specific Physical Symptom Biology in Heart Failure

Lee

Hiatt

Denfeld

et al. 2015

Journal of Cardiovascular Nursing

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Background There are several gender differences that may help explain the link between biology and symptoms in heart failure (HF). Objective The aim of this study was to examine gender-specific relationships between objective measures of HF severity and physical symptoms. Methods Detailed clinical data, including left ventricular ejection fraction and left ventricular internal end-diastolic diameter, and HF-specific physical symptoms were collected as part of a prospective cohort study. Gender interaction terms were tested in linear regression models of physical symptoms. Results The sample (101 women and 101 men) averaged 57 years of age and a majority of participants (60%) had class III/IV HF. Larger left ventricle size was associated with better physical symptoms for women and worse physical symptoms for men. Conclusion Decreased ventricular compliance may result in worse physical HF symptoms for women and dilation of the ventricle may be a greater progenitor of symptoms for men with HF.

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Symptoms in heart failure correlate poorly with objective haemodynamic parameters

Abstract: Overall, the correlation between symptoms and objective parameters was weak. Because of low magnitude of relationship between symptoms to objective parameters, it was concluded that there are likely other factors determining the perception of symptoms in HF patients.

Cited by 26 publications

References 11 publications

The relationship between pain, fatigue, depression and functional performance in stable heart failure

The relationship between pain, fatigue, depression and functional performance in stable heart failure

Symptom-Hemodynamic Mismatch and Heart Failure Event Risk

Gender-Specific Physical Symptom Biology in Heart Failure

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