title: Physical and psychological symptom biomechanics in moderate to advanced heart failure.
abstract: BACKGROUND
  There is a common dissociation between objective measures and patient symptomatology in heart failure (HF).
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Cardiac biomechanics were related to physical symptoms and anxiety, providing preliminary evidence of the biological underpinnings of symptomatology among adults with HF.
authors.affiliation: 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.
authors.forename: Quin E
authors.initials: QE
authors.lastname: Denfeld
authors.forename: James O
authors.initials: JO
authors.lastname: Mudd
authors.forename: Jill M
authors.initials: JM
authors.lastname: Gelow
authors.forename: Christopher
authors.initials: C
authors.lastname: Chien
authors.forename: Shirin O
authors.initials: SO
authors.lastname: Hiatt
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Lee
mesh_terms: D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D063189:Symptom Assessment