Loading...
Sympathetic dysfunction is associated with worse fatigue and early and subtle symptoms in heart failure : An exploratory sex-stratified analysis
Stutsman, Nina Habecker, Beth Pavlovic, Noelle Jurgens, Corrine Y. Woodward, William R. Lee, Christopher S. Denfeld, Quin E.
Stutsman, Nina
Habecker, Beth
Pavlovic, Noelle
Jurgens, Corrine Y.
Woodward, William R.
Lee, Christopher S.
Denfeld, Quin E.
Abstract
Aims
Physical symptoms impact patients with heart failure (HF) despite treatment advancements; however, our understanding of the pathogenic mechanisms underlying HF symptoms remains limited, including sex differences therein. The objective of this study was to quantify associations between sympathetic markers [norepinephrine (NE) and 3,4-dihydroxyphenylglycol (DHPG)] and physical symptoms in patients with HF and to explore sex differences in these associations.
Methods and results
We performed a secondary analysis of combined data from two studies: outpatients with HF (n = 111), and patients prior to left ventricular assist device implantation (n = 38). Physical symptoms were measured with the Heart Failure Somatic Perception Scale (HFSPS) dyspnoea and early/subtle symptom subscales and the Functional Assessment in Chronic Illness Therapy Fatigue Scale (FACIT-F) to capture dyspnoea, early symptoms of decompensation, and fatigue. Norepinephrine and DHPG were measured with high-performance liquid chromatography with electrochemical detection. Multivariate linear regression was used to quantify associations between symptoms and sympathetic markers. The sample (n = 149) was 60.8 ± 15.7 years, 41% women, and 71% non-ischaemic aetiology. Increased plasma NE and NE:DHPG ratio were associated with worse FACIT-F scores (P = 0.043 and P = 0.013, respectively). Increased plasma NE:DHPG ratio was associated with worse HFSPS early/subtle symptoms (P = 0.025). In sex-stratified analyses, increased NE:DHPG ratio was associated with worse FACIT-F scores (P = 0.011) and HFSPS early/subtle scores (P = 0.022) among women but not men.
Conclusion
In patients with HF, sympathetic dysfunction is associated with worse fatigue and early/subtle physical symptoms with associations stronger in women than men.
Keywords
biomarkers, heart failure, sex differences, sympathetic nervous system, symptoms
Date
2024
Type
Journal article
Journal
European Journal of Cardiovascular Nursing
Book
Volume
23
Issue
5
Page Range
532-539
Article Number
ACU Department
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled
Notes
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.