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Comparative symptom biochemistry between moderate and advanced heart failure
Christopher S Lee1, Quin E Denfeld2, Bradley E Aouizerat3
1Professor and Associate Dean for Research, Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Maloney Hall 226, Chestnut Hill, MA, United States.
Heart & Lung : the Journal of Critical Care
|October 14, 2018
Summary
Biological factors like myocardial stress and inflammation impact heart failure (HF) symptoms differently in moderate versus advanced HF patients. Understanding a patient's HF stage is crucial for interpreting symptom causes.
Area of Science:
- Cardiology
- Biomedical Science
- Clinical Research
Background:
- Limited understanding of the biological basis of heart failure (HF) symptoms.
- Need to explore the relationship between peripheral biomarkers and physical manifestations of HF.
Purpose of the Study:
- Compare relationships between peripheral biomarkers and physical symptoms in moderate versus advanced HF.
- Investigate how HF stage influences the biological underpinnings of symptoms.
Main Methods:
- Two-stage phenotype sampling cohort study.
- Examined patients with advanced HF (ventricular assist device implantation) and moderate HF (no device).
- Utilized linear modeling to compare biomarker-symptom relationships between cohorts.
Main Results:
- In moderate HF, worse myocardial stress, systemic inflammation, and endothelial dysfunction correlated with increased physical symptoms.
- In advanced HF, these same biological factors were associated with a lesser symptom burden.
- Significant differences in biomarker-symptom associations were observed between the two HF stages.
Conclusions:
- The patient's position in the heart failure (HF) trajectory is a critical factor.
- Biological underpinnings of physical HF symptoms vary significantly based on disease severity.
- Future research should stratify HF patients by disease stage when investigating symptom etiology.
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