William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Maloney Hall, Chestnut Hill, MA 02467, United States; Stony Brook University School of Nursing, Nicolls Road, Health Sciences Center Level 2 - Room 204, Stony Brook, NY 11794, United States.
William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Maloney Hall, Chestnut Hill, MA 02467, United States.
Heart Lung. 2020 Sep-Oct;49(5):488-494. doi: 10.1016/j.hrtlng.2020.03.026. Epub 2020 May 18.
Dyspnea is a common symptom of heart failure (HF) but dyspnea burden is highly variable.
Identify distinct profiles of dyspnea burden and identify predictors of dyspnea symptom profile.
A secondary analysis of data from five studies completed at Oregon Health and Science University was conducted. The Heart Failure Somatic Perception Scale was used to measure dyspnea burden. Latent class mixture modeling identified distinct profiles of dyspnea burden in a sample of HF patients (n = 449). Backwards stepwise multinomial logistic regression identified predictors of latent profile membership.
Four profiles of dyspnea burden were identified: no dyspnea/not bothered by dyspnea, mild dyspnea, moderate exertional dyspnea, and moderate exertional dyspnea with orthopnea and PND. Higher age was associated with greater likelihood of not being bothered by dyspnea than having moderate exertional dyspnea with orthopnea and PND. Higher NYHA class, anxiety, and depression were associated with greater likelihood of greater dyspnea burden.
Burden of dyspnea is highly variable among HF patients. Clinicians should account for the nuances of dyspnea and the activities that induce dyspnea when assessing HF patients.
呼吸困难是心力衰竭（HF）的常见症状，但呼吸困难负担的差异很大。
确定呼吸困难负担的不同特征，并确定呼吸困难症状特征的预测因素。
对俄勒冈健康与科学大学进行的五项研究的数据进行二次分析。使用心力衰竭躯体知觉量表来衡量呼吸困难负担。潜在类别混合模型在心力衰竭患者样本（n=449）中确定了不同的呼吸困难负担特征。向后逐步多项逻辑回归确定了潜在特征成员的预测因素。
确定了四种呼吸困难负担特征：无呼吸困难/无呼吸困难困扰、轻度呼吸困难、中等劳累性呼吸困难和伴有端坐呼吸和夜间阵发性呼吸困难的中等劳累性呼吸困难。年龄较高与无呼吸困难困扰而不是伴有端坐呼吸和夜间阵发性呼吸困难的中度劳累性呼吸困难的可能性更大相关。较高的 NYHA 分级、焦虑和抑郁与更大的呼吸困难负担的可能性更大相关。
心力衰竭患者的呼吸困难负担差异很大。临床医生在评估心力衰竭患者时应考虑呼吸困难的细微差别以及引起呼吸困难的活动。
