Institution: | 1. Professor and Associate Dean for Research, Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Maloney Hall 226, Chestnut Hill, MA, United States;2. Oregon Health & Science School of Nursing, Portland, OR, United States;3. New York University Department of Oral and Maxillofacial Surgery, New York, NY, United States;4. Stony Brook University School of Nursing, Stony Brook, NY, United States;5. University of North Carolina REX Healthcare, Raleigh, NC, United States;6. Boston College William F. Connell School of Nursing, Chestnut Hill, MA, United States;7. Providence Health, Portland, OR, United States;8. Oregon Health & Science University School of Nursing, Portland, OR, United States;9. Oregon Health & Science University Knight Cardiovascular Institute, Portland, OR, United States |
Abstract: | BackgroundWe have a limited understanding of the biological underpinnings of symptoms in heart failure (HF).ObjectivesThe purpose of this paper was to compare relationships between peripheral biomarkers of HF pathogenesis and physical symptoms between patients with advanced versus moderate HF.MethodsThis was a two-stage phenotype sampling cohort study wherein we examined patients with advanced HF undergoing ventricular assist device implantation in the first stage, and then patients with moderate HF (matched adults with HF not requiring device implantation) in the second stage. Linear modeling was used to compare relationships among biomarkers and physical symptoms between cohorts.ResultsWorse myocardial stress, systemic inflammation and endothelial dysfunction were associated with worse physical symptoms in moderate HF (n=48), but less physical symptom burden in advanced HF (n=48).ConclusionsWhere patients are in the HF trajectory needs to be taken into consideration when exploring biological underpinnings of physical HF symptoms. |