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Heart failure symptom science: Is adrenergic dysregulation a missing link?

      Heart failure (HF), a complex and heterogeneous epidemic, manifested by disabling physical symptoms like dyspnea and fatigue, and affective symptoms like depression and anxiety, is the fastest growing cardiovascular disorder in the U.S. and the number one reason for hospitalization among older adults.
      • Ross J.S.
      • Chen J.
      • Lin Z.
      • et al.
      Recent national trends in readmission rates after heart failure hospitalization.
      • Heidenreich P.A.
      • Trogdon J.G.
      • Khavjou O.A.
      • et al.
      Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association.
      Notwithstanding various etiological and structural characteristics (e.g. ischemic vs. non-ischemic, reduced vs. preserved ejection fraction, etc.), hallmark symptoms like dyspnea and fatigue are what connect varied cases of HF together under a single diagnosis.
      • Yancy C.W.
      • Jessup M.
      • Bozkurt B.
      • et al.
      2013 ACCF/AHA Guideline for the Management of Heart Failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.
      Symptoms are so important in understanding HF because they are the main progenitor of healthcare utilization, independent predictors of event-risk, and principal drivers of quality of life.
      • Lee C.S.
      • Hiatt S.O.
      • Denfeld Q.E.
      • Mudd J.O.
      • Chien C.
      • Gelow J.M.
      Symptom-hemodynamic mismatch and heart failure event risk.
      Moreover, monitoring for symptoms is also the key link between routine HF self-care behaviors geared toward preventing acute exacerbations and the complex self-care behaviors that are required to manage the signs and symptoms of worsening congestion.
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      References

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        • Lin Z.
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        Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association.
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