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® Index exceeding 60 Ω threshold) with HRQOL (12-item Kansas City Cardiomyopathy Questionnaire)
and both physical symptoms (Functional Assessment of Chronic Illness Therapy-Fatigue
Scale; HF Somatic Perception Scale Dyspnea and Early & Subtle Symptoms subscales)
and affective symptoms (9-item Patient Health Questionnaire; 6-item Patient-Reported
Outcomes Measurement Information System Anxiety Scale).
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.
Keywords
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Article info
Publication history
Published online: January 02, 2019
Accepted:
December 4,
2018
Received in revised form:
November 7,
2018
Received:
August 12,
2018
Footnotes
☆Funding: This work was supported by the National Institute of Nursing Research (F31NR016660). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
