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与心力衰竭黑人成年人的症状及社区贫困相关的炎症标志物

Inflammation markers associated with symptoms and neighborhood deprivation in black adults with heart failure.

作者信息

Butts Brittany, Herring Christopher, Madariaga Andrea, Graven Lucinda J, Higgins Melinda K, Dunbar Sandra B

机构信息

Emory University School of Nursing, 1520 Clifton Rd NE, Atlanta, GA 30322, USA.

Emory University School of Nursing, 1520 Clifton Rd NE, Atlanta, GA 30322, USA.

出版信息

Heart Lung. 2025 Jul 9;74:121-128. doi: 10.1016/j.hrtlng.2025.07.001.

Abstract

BACKGROUND

Black adults face a higher prevalence of heart failure (HF), with greater symptom burden and earlier onset compared to other populations. Systemic inflammation and socioeconomic factors, including neighborhood deprivation, contribute to these disparities. Understanding the interplay between inflammation, HF symptoms, and social determinants of health is critical for addressing inequities in HF outcomes.

OBJECTIVES

This study examines associations between inflammatory biomarkers and physical and psychological symptoms in Black adults with HF and explores the impact of neighborhood deprivation on these factors.

METHODS

Black adults with HF (N = 41) were enrolled in this cross-sectional study. Blood samples were collected using Mitra Microsampling for biomarker analysis, including cytokines, chemokines, and xanthine oxidase (XO) activity. Symptoms were assessed using validated measures for dyspnea, fatigue, anxiety, depression, stress, and sleep disturbance. Neighborhood deprivation was evaluated using the Area Deprivation Index.

RESULTS

Elevated XO activity was significantly associated with dyspnea severity (β = 0.75, p < .001). Chemokines linked to T cell activation (e.g., CC motif ligand[CCL]-11, CXC motif ligand[CXCL]-8) correlated with HF symptoms and psychological distress, including anxiety and perceived stress. Higher neighborhood deprivation scores were associated with increased stress, sleep disturbance, and inflammatory biomarkers (e.g., interleukin[IL]-4, vascular cell adhesion molecule[VCAM]-1).

CONCLUSIONS

This study highlights the role of inflammation and neighborhood deprivation in HF symptomatology among Black adults. Targeting oxidative stress and inflammatory pathways, alongside addressing social determinants of health, may reduce symptom burden and improve outcomes in this population.

摘要

背景

与其他人群相比,成年黑人患心力衰竭(HF)的患病率更高,症状负担更重且发病更早。全身炎症和社会经济因素,包括邻里贫困,导致了这些差异。了解炎症、心力衰竭症状和健康的社会决定因素之间的相互作用对于解决心力衰竭结局的不平等问题至关重要。

目的

本研究探讨了成年黑人心力衰竭患者炎症生物标志物与身体和心理症状之间的关联,并探讨了邻里贫困对这些因素的影响。

方法

41名成年黑人心力衰竭患者参与了这项横断面研究。使用Mitra微量采样收集血样以进行生物标志物分析,包括细胞因子、趋化因子和黄嘌呤氧化酶(XO)活性。使用经过验证的方法评估呼吸困难、疲劳、焦虑、抑郁、压力和睡眠障碍等症状。使用地区贫困指数评估邻里贫困情况。

结果

XO活性升高与呼吸困难严重程度显著相关(β = 0.75,p <.001)。与T细胞活化相关的趋化因子(如CC基序配体[CCL]-11、CXC基序配体[CXCL]-8)与心力衰竭症状和心理困扰相关,包括焦虑和感知压力。更高的邻里贫困得分与压力增加、睡眠障碍和炎症生物标志物(如白细胞介素[IL]-4、血管细胞黏附分子[VCAM]-1)相关。

结论

本研究强调了炎症和邻里贫困在成年黑人心力衰竭症状学中的作用。针对氧化应激和炎症途径,同时解决健康的社会决定因素,可能会减轻该人群的症状负担并改善结局。

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