Related Experiment Video
Updated: Jan 25, 2026

Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach
Published on: July 21, 2023
Sex Differences in Heart Failure Symptoms and Factors Associated With Heart Failure Symptoms
Seongkum Heo1, Mi-Seung Shin, Seon Young Hwang
1Seongkum Heo, PhD, RN Associate Professor, College of Nursing, University of Arkansas for Medical Sciences, Little Rock. Mi-Seung Shin, PhD, MD Professor, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea. Seon Young Hwang, PhD, RN Professor, College of Nursing, Hanyang University, Seoul, South Korea. Minjeong An, PhD, RN Associate Professor, College of Nursing, Chonnam National University, Gwangju, South Korea. Jin-Kyu Park, PhD, MD Associate Professor, Department of Cardiology, Hanyang University Seoul Hospital, South Korea. SunHwa Kim, PhD, RN Nurse, Stroke Unit, Hanyang University Medical Center, Seoul, South Korea. Jae Lan Shim, PhD Department of Nursing, College of Medicine, Assistant Professor, Dongguk University, Gyeongju, South Korea. JinShil Kim, PhD, RN Professor, College of Nursing, Gachon University, Incheon, South Korea. The authors have no conflicts of interest to disclose.
Background:
A majority of patients with heart failure (HF) experience HF symptoms. Some literature suggests sex differences in the status of and also factors associated with HF symptoms. However, information on common HF symptom status and factors associated with HF symptoms in male and female patients is scarce.
Objectives:
The aim of this study was to examine HF symptom status and factors associated with HF symptoms in male and female patients with HF.
Methods:
Descriptive data on HF symptoms, psychological factors (depressive symptoms and perceived control), sociodemographic factors (age and sex), clinical factors (body mass index, comorbidities, medication, and left ventricular ejection fraction), and a behavioral factor (self-care) were collected in 70 male and 49 female patients with HF. Mann-Whitney U tests, χ tests, and stepwise regression models were used to address the objectives.
Results:
Fatigue was the most common HF symptom in both sexes, but male patients had less severe HF symptoms, including frequency, severity, and/or distress. In male patients, 2 psychological and 2 clinical factors (comorbidities and use of diuretics) were significantly associated with HF symptoms (adjusted R = 0.669, P < .001), whereas in female patients, only depressive symptoms were significantly associated with HF symptoms (adjusted R = 0.679, P < .001).
Discussion:
There were sex differences in HF symptoms and the factors associated with HF symptoms. Clinicians and researchers need to recognize and manage psychological factors in both sexes and clinical factors in male patients by using effective interventions to improve HF symptoms.
Related Concept Videos
Heart Failure II: Pathophysiology
Pathophysiology of Heart Failure
Heart Failure I: Introduction
Heart Failure VI: Adjunct Therapies
Heart Failure Drugs: Diuretics
Heart Failure V: Medical Management

