Keywords

heart failure, physical frailty, symptoms

 

Authors

  1. Denfeld, Quin E. PhD, RN
  2. Winters-Stone, Kerri PhD, FACSM
  3. Mudd, James O. MD
  4. Hiatt, Shirin O. MS, MPH, RN
  5. Lee, Christopher S. PhD, RN, FAHA, FAAN, FHFSA

Abstract

Background: Heart failure (HF) is a complex clinical syndrome associated with significant symptom burden; however, our understanding of the relationship between symptoms and physical frailty in HF is limited.

 

Objective: The aim of this study was to quantify associations between symptoms and physical frailty in adults with HF.

 

Methods: A sample of adults with symptomatic HF were enrolled in a cross-sectional study. Physical symptoms were measured with the HF Somatic Perception Scale-Dyspnea subscale, the Epworth Sleepiness Scale, and the Brief Pain Inventory short form. Affective symptoms were measured with the Patient Health Questionnaire-9 and the Brief Symptom Inventory-Anxiety scale. Physical frailty was assessed according to the Frailty Phenotype Criteria: shrinking, weakness, slowness, physical exhaustion, and low physical activity. Comparative statistics and generalized linear modeling were used to quantify associations between symptoms and physical frailty, controlling for Seattle HF Model projected 1-year survival.

 

Results: The mean age of the sample (n = 49) was 57.4 +/- 9.7 years, 67% were male, 92% had New York Heart Association class III/IV HF, and 67% had nonischemic HF. Physically frail participants had more than twice the level of dyspnea (P < .001), 75% worse wake disturbances (P < .001), and 76% worse depressive symptoms (P = .003) compared with those who were not physically frail. There were no differences in pain or anxiety.

 

Conclusions: Physically frail adults with HF have considerably worse dyspnea, wake disturbances, and depression. Targeting physical frailty may help identify and improve physical and affective symptoms in HF.