biomechanics, heart failure, hemodynamics, symptoms



  1. Denfeld, Quin E. BSN, RN
  2. Mudd, James O. MD
  3. Gelow, Jill M. MD, MPH
  4. Chien, Christopher MD
  5. Hiatt, Shirin O. MPH, MS, RN
  6. Lee, Christopher S. PhD, RN, FAHA


Background: There is a common dissociation between objective measures and patient symptomatology in heart failure (HF).


Objective: The aim of this study was to explore the relationship between cardiac biomechanics and physical and psychological symptoms in adults with moderate to advanced HF.


Methods: We performed a secondary analysis of data from 2 studies of symptoms among adults with HF. Stepwise regression modeling was performed to examine the influence of cardiac biomechanics (left ventricular internal diastolic diameter, right atrial pressure [RAP], and cardiac index) on symptoms.


Results: The average age of the sample (n = 273) was 57 +/- 16 years, 61% were men, and 61% had class III or IV HF. Left ventricular internal diastolic diameter ([beta] = 4.22 +/- 1.63, P = .011), RAP ([beta] = 0.71 +/- 0.28, P = .013), and cardiac index ([beta] = 7.11 +/- 3.19, P = .028) were significantly associated with physical symptoms. Left ventricular internal diastolic diameter ([beta] = 0.10 +/- 0.05, P = .038) and RAP ([beta] = 0.03 +/- 0.01, P = .039) were significantly associated with anxiety. There were no significant biomechanical determinants of depression.


Conclusion: Cardiac biomechanics were related to physical symptoms and anxiety, providing preliminary evidence of the biological underpinnings of symptomatology among adults with HF.