Identifying unique profiles of perceived dyspnea burden in heart failure.
Kenneth M Faulkner, Corrine Y Jurgens, Quin E Denfeld and 3 others
PMID 32434702WHAT IT FOUND
Heart failure patients fall into four distinct groups based on how much dyspnea bothers them, not just if they have it.
Older patients were less likely to report severe bother despite similar symptoms. Anxiety and depression predicted higher burden. Assessing what activities trigger breathlessness helps tailor care.
Key findings
01Four distinct profiles of dyspnea burden were identified: no dyspnea/not bothered (38.4%), mild dyspnea (13.7%), moderate exertional dyspnea (28.3%), and moderate exertional dyspnea with orthopnea/PND (19.6%).
02Older patients were less likely to be in the most burdensome profile (moderate exertional dyspnea with orthopnea/PND) compared to the no dyspnea profile, suggesting age may suppress reported bother.
03Higher anxiety and depression scores, along with worse NYHA functional class, were significant predictors of belonging to profiles with greater dyspnea burden.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The sample was predominantly male, White, and recruited from a single academic center, limiting generalizability. Data were collected at a single time point, so changes in dyspnea profiles over time or in response to treatment were not observed. The study identified associations between clinical factors and dyspnea profiles but did not link these profiles to hard outcomes like hospitalization or mortality. Self-reported symptom burden may be influenced by cognitive dysfunction or coping strategies, which were not fully accounted for in the analysis.
Declared interests
Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't. No other conflicts declared.
The easy way to misread this
Do not assume that patients who report low dyspnea burden are physically stable or have mild disease. Older patients and those with developed coping strategies may report less bother despite significant physiological impairment. Conversely, high reported burden is strongly associated with anxiety and depression, which may require psychological management alongside cardiac care.