Device-detected congestion is associated with worse patient-reported outcomes in heart failure.

Document Type

Article

Publication Date

5-1-2019

Publication Title

Heart & lung : the journal of critical care

Keywords

Cardiography, Impedance; Dyspnea; Female; Heart Failure; Humans; Male; Middle Aged; Monitoring, Ambulatory; Patient Reported Outcome Measures; Quality of Life; Retrospective Studies; cards

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

RESULTS: The mean age of the sample (n = 49) was 62years old, 39% were women, and 63% had NYHA class III/IV HF. Participants who experienced threshold crossings in the previous 90days 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 90days 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 3months.

Clinical Institute

Cardiovascular (Heart)

Department

Cardiology

Department

Center for Cardiovascular Analytics, Research + Data Science (CARDS)

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