Abstract
Background: Congestion is a common cause of symptoms in heart failure (HF). Yet, intrathoracic impedance, an objective marker of cardiopulmonary congestion, has not been examined in relation to HF symptoms. Objective: To determine whether device-detected cardiopulmonary congestion is a predictor of physical and psychological symptoms and health-related quality of life (HRQOL) in adults with HF over 3 months. Methods: Multivariate generalized linear modeling was used to quantify the association of cardiopulmonary congestion (Optivol® Index exceeding 60 Ω threshold) with HRQOL (12-item Kansas City Cardiomyopathy Questionnaire) and both physical symptoms (Functional Assessment of Chronic Illness Therapy-Fatigue Scale; HF Somatic Perception Scale Dyspnea and Early & Subtle Symptoms subscales) and affective symptoms (9-item Patient Health Questionnaire; 6-item Patient-Reported Outcomes Measurement Information System Anxiety Scale). Results: The mean age of the sample (n = 49) was 62 years old, 39% were women, and 63% had NYHA class III/IV HF. Participants who experienced threshold crossings in the previous 90 days reported on average, 130% higher dyspnea (p = 0.017; confidence interval (CI) 10.2%, 437%), 40% higher early & subtle symptoms (p = 0.029; CI 3.4%, 89.7%), 106% higher depressive symptoms (p = 0.003; CI 19.1%, 257%) and 40% higher anxiety (p = 0.028; CI 3.7%, 89.1%). Threshold crossings in the previous 90 days were also significantly associated with a clinically meaningful decrease in HRQOL (β = −16.16 ± 6.32; p = 0.01). Conclusions: Intrathoracic impedance measured with the Optivol Index can provide additional information regarding the patient experience of hallmark physical and psychological HF symptoms and HRQOL over 3 months.
| Original language | English (US) |
|---|---|
| Journal | Heart and Lung |
| DOIs | |
| State | Accepted/In press - Jan 1 2019 |
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Keywords
- Heart failure
- Intrathoracic impedance
- Pulmonary congestion
- Quality of life
- Symptom
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine
Cite this
Device-detected congestion is associated with worse patient-reported outcomes in heart failure. / Auld, Jonathan P.; Mudd, James; Gelow, Jill; Lyons, Karen; Hiatt, Shirin O.; Lee, Christopher.
In: Heart and Lung, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Device-detected congestion is associated with worse patient-reported outcomes in heart failure
AU - Auld, Jonathan P.
AU - Mudd, James
AU - Gelow, Jill
AU - Lyons, Karen
AU - Hiatt, Shirin O.
AU - Lee, Christopher
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Congestion is a common cause of symptoms in heart failure (HF). Yet, intrathoracic impedance, an objective marker of cardiopulmonary congestion, has not been examined in relation to HF symptoms. Objective: To determine whether device-detected cardiopulmonary congestion is a predictor of physical and psychological symptoms and health-related quality of life (HRQOL) in adults with HF over 3 months. Methods: Multivariate generalized linear modeling was used to quantify the association of cardiopulmonary congestion (Optivol® Index exceeding 60 Ω threshold) with HRQOL (12-item Kansas City Cardiomyopathy Questionnaire) and both physical symptoms (Functional Assessment of Chronic Illness Therapy-Fatigue Scale; HF Somatic Perception Scale Dyspnea and Early & Subtle Symptoms subscales) and affective symptoms (9-item Patient Health Questionnaire; 6-item Patient-Reported Outcomes Measurement Information System Anxiety Scale). Results: The mean age of the sample (n = 49) was 62 years old, 39% were women, and 63% had NYHA class III/IV HF. Participants who experienced threshold crossings in the previous 90 days reported on average, 130% higher dyspnea (p = 0.017; confidence interval (CI) 10.2%, 437%), 40% higher early & subtle symptoms (p = 0.029; CI 3.4%, 89.7%), 106% higher depressive symptoms (p = 0.003; CI 19.1%, 257%) and 40% higher anxiety (p = 0.028; CI 3.7%, 89.1%). Threshold crossings in the previous 90 days were also significantly associated with a clinically meaningful decrease in HRQOL (β = −16.16 ± 6.32; p = 0.01). Conclusions: Intrathoracic impedance measured with the Optivol Index can provide additional information regarding the patient experience of hallmark physical and psychological HF symptoms and HRQOL over 3 months.
AB - Background: Congestion is a common cause of symptoms in heart failure (HF). Yet, intrathoracic impedance, an objective marker of cardiopulmonary congestion, has not been examined in relation to HF symptoms. Objective: To determine whether device-detected cardiopulmonary congestion is a predictor of physical and psychological symptoms and health-related quality of life (HRQOL) in adults with HF over 3 months. Methods: Multivariate generalized linear modeling was used to quantify the association of cardiopulmonary congestion (Optivol® Index exceeding 60 Ω threshold) with HRQOL (12-item Kansas City Cardiomyopathy Questionnaire) and both physical symptoms (Functional Assessment of Chronic Illness Therapy-Fatigue Scale; HF Somatic Perception Scale Dyspnea and Early & Subtle Symptoms subscales) and affective symptoms (9-item Patient Health Questionnaire; 6-item Patient-Reported Outcomes Measurement Information System Anxiety Scale). Results: The mean age of the sample (n = 49) was 62 years old, 39% were women, and 63% had NYHA class III/IV HF. Participants who experienced threshold crossings in the previous 90 days reported on average, 130% higher dyspnea (p = 0.017; confidence interval (CI) 10.2%, 437%), 40% higher early & subtle symptoms (p = 0.029; CI 3.4%, 89.7%), 106% higher depressive symptoms (p = 0.003; CI 19.1%, 257%) and 40% higher anxiety (p = 0.028; CI 3.7%, 89.1%). Threshold crossings in the previous 90 days were also significantly associated with a clinically meaningful decrease in HRQOL (β = −16.16 ± 6.32; p = 0.01). Conclusions: Intrathoracic impedance measured with the Optivol Index can provide additional information regarding the patient experience of hallmark physical and psychological HF symptoms and HRQOL over 3 months.
KW - Heart failure
KW - Intrathoracic impedance
KW - Pulmonary congestion
KW - Quality of life
KW - Symptom
UR - http://www.scopus.com/inward/record.url?scp=85059326133&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85059326133&partnerID=8YFLogxK
U2 - 10.1016/j.hrtlng.2018.12.003
DO - 10.1016/j.hrtlng.2018.12.003
M3 - Article
JO - Heart and Lung: Journal of Acute and Critical Care
JF - Heart and Lung: Journal of Acute and Critical Care
SN - 0147-9563
ER -