Association between stress and physical activity by heart failure phenotype

Area of Science:

• Cardiology
• Endocrinology
• Psychology

Background:

• Cortisol, a key stress biomarker, is hypothesized to impact physical activity tolerance.
• Heart failure (HF) presents diverse phenotypes: systolic, diastolic, and combined.
• Understanding stress's role in HF patients' physical activity is crucial for management.

Purpose of the Study:

• To investigate the association between subjective and objective stress markers and physical activity (PA) in patients with different heart failure phenotypes.
• To explore the relationship between hair cortisol concentration (HCC) and perceived stress in systolic, diastolic, and combined HF.

Main Methods:

• A cross-sectional study involving patients with diagnosed heart failure.
• Subjective stress assessed using the Perceived Stress Scale (PSS-10).
• Objective stress measured via hair cortisol concentration (HCC). Physical activity evaluated using the International Physical Activity Questionnaire Short Form (IPAQ-SF).

Main Results:

• Low physical activity levels were observed across all heart failure groups.
• Combined HF patients exhibited a trend towards lower PA, higher perceived stress, and higher HCC.
• Hair cortisol concentration (HCC) showed a strong positive association with physical activity (PA) in diastolic HF patients (r=0.91).

Conclusions:

• A dissociation between psychological and physiological stress markers was observed.
• Physical activity (PA) may act as a physiological stressor, particularly in diastolic heart failure, as indicated by the positive HCC association.
• Combined HF patients displayed elevated stress markers, warranting further investigation into their complex stress physiology.