Denfeld Quin E, Mudd James O, Gelow Jill M, Chien Christopher, Hiatt Shirin O, Lee Christopher S
Quin E. Denfeld, BSN, RN PhD Student, School of Nursing, Oregon Health & Science University, Portland. James O. Mudd, MD Assistant Professor, Knight Cardiovascular Institute, Oregon Health & Science University, Portland. Jill M. Gelow, MD, MPH Assistant Professor, Knight Cardiovascular Institute, Oregon Health & Science University, Portland. Christopher Chien, MD Assistant Professor, Knight Cardiovascular Institute, Oregon Health & Science University, Portland. Shirin O. Hiatt, MPH, MS, RN Research Associate, School of Nursing, Oregon Health & Science University, Portland. Christopher S. Lee, PhD, RN, FAHA Assistant Professor, School of Nursing and Knight Cardiovascular Institute, Oregon Health & Science University, Portland.
J Cardiovasc Nurs. 2015 Jul-Aug;30(4):346-50. doi: 10.1097/JCN.0000000000000171.
There is a common dissociation between objective measures and patient symptomatology in heart failure (HF).
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.
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.
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 (β = 4.22 ± 1.63, P = .011), RAP (β = 0.71 ± 0.28, P = .013), and cardiac index (β = 7.11 ± 3.19, P = .028) were significantly associated with physical symptoms. Left ventricular internal diastolic diameter (β = 0.10 ± 0.05, P = .038) and RAP (β = 0.03 ± 0.01, P = .039) were significantly associated with anxiety. There were no significant biomechanical determinants of depression.
Cardiac biomechanics were related to physical symptoms and anxiety, providing preliminary evidence of the biological underpinnings of symptomatology among adults with HF.
在心力衰竭（HF）中，客观测量指标与患者症状之间通常存在脱节。
本研究旨在探讨中重度HF成人患者心脏生物力学与身体和心理症状之间的关系。
我们对两项HF成人患者症状研究的数据进行了二次分析。采用逐步回归模型来检验心脏生物力学（左心室内径、右心房压力[RAP]和心脏指数）对症状的影响。
样本（n = 273）的平均年龄为57±16岁，61%为男性，61%患有Ⅲ或Ⅳ级HF。左心室内径（β = 4.22±1.63，P = .011）、RAP（β = 0.71±0.28，P = .013）和心脏指数（β = 7.11±3.19，P = .028）与身体症状显著相关。左心室内径（β = 0.10±0.05，P = .038）和RAP（β = 0.03±0.01，P = .039）与焦虑显著相关。不存在抑郁的显著生物力学决定因素。
心脏生物力学与身体症状和焦虑相关，为HF成人患者症状的生物学基础提供了初步证据。
