Abstract 13237: Impact of Pain and Heart Failure Symptom Severity on Physical Performance
Introduction: The purpose was to determine whether pain and heart failure (HF) symptom severity are associated with physical performance in patients with advanced HF.
Methods: Cross-sectional data were analyzed on 160 adults with advanced HF (dyspnea or fatigue at rest or with minimal exertion despite optimal medical therapy). Demographics, comorbidity (Charlson), pain (Brief Pain Inventory), HF symptom severity (Kansas City Cardiomyopathy Questionnaire), and depression (Patient Health Questionnaire-9) data were obtained. Physical function was assessed with the Short Physical Performance Battery (SPPB), a measure of lower extremity function (timed walking speed, standing balance, chair rises). Scores range 0-12 (higher scores=better). Multivariable linear regression assessed the associations of pain and HF symptom severity with SPPB scores.
Results: Subjects had a mean (standard deviation [SD]) age of 67.0 (15.9) years, 43% were women, and 19.6% were non-white. The mean (SD) SPPB score was 6.4 (3.6), indicating limited mobility function. Subjects in the highest quartile of pain (severe), as compared to those in the lowest quartile, had clinically significant decreased SPPB scores (b coefficient = -2.1; p<0.01), adjusting for demographics, comorbidity, and depression. However, this association was no longer significant when adjusting for HF symptom severity. For every SD increase in HF symptom severity, SPPB scores decreased 1.2 points (p<0.01). The combined effect of pain and HF symptom severity on SPPB scores (Table) suggests that pain exacerbates the impact of HF symptom severity on physical performance.
Conclusions: Among patients with advanced HF, symptom severity was strongly associated with decreased physical performance. Pain may exacerbate HF symptom severity and contribute to decline in mobility function.
Author Disclosures: S. Wingate: None. K.V. Patel: None. J. Guralnik: None. S. Goodlin: None.
- © 2014 by American Heart Association, Inc.