Abstract 17942: Identifying Heart Failure Patients Less Likely to Report Dyspnea
Background: Dyspnea is a hallmark symptom of heart failure (HF); yet, many patients living with HF do not experience this symptom.
Purpose: The purpose of the study was to identify clinical and psychosocial factors related to the presence or absence of dyspnea among patients with chronic HF.
Method: We completed a secondary analysis of data collected on unique participants from two prospective cohort studies conducted by a single team of HF investigators from 2010 to 2013. Dyspnea symptoms were assessed using the 6-item HF Somatic Perception Scale dyspnea subscale (HFSPSD) that is known to independently predict clinical outcomes in HF. Clinical data were extracted from the electronic medical record and additional demographic and symptom data were collected by survey including the brief symptom inventory anxiety scale (0-4; higher is worse). Multivariate logistic regression modeling was used to identify determinants of having dyspnea (HFSPSD score > 0) vs not having dyspnea (HFSPSD score = 0).
Results: The sample (n=274) was predominantly male (62.8%), of middle age (mean = 55.4±13.6 years) and symptomatic with class III/IV HF (76.4%). A majority of patients (75.2%) reported having dyspnea but 24.8% of participants reported having no dyspnea symptoms. Adjusting for gender, education, comorbidities, HF etiology, body mass, and treatment with evidence-based therapies, age (OR = 0.96 per year; p=0.02), being married/partnered (OR = 2.07; p=0.03), class III/IV vs. class II HF (OR = 2.90; p<0.01) and anxiety (OR = 1.30 per point; p<0.01) were independently associated with experiencing dyspnea.
Conclusions: Persons with HF who are older, un-married/-partnered, have class II HF and/or have lower levels of anxiety are less likely to report dyspnea. Health providers of patients fitting this profile must learn to evaluate symptoms other than dyspnea as signs of HF severity and potentially exacerbations.
Author Disclosures: C.Y. Jurgens: Employment; Significant; Faculty-Stony Brook University. R.M. Masterson Creber: None. C.S. Lee: Research Grant; Significant; NIH.
- © 2016 by American Heart Association, Inc.