Identifying unique profiles of perceived dyspnea burden in heart failure

Abstract

Background: Dyspnea is a common symptom of heart failure (HF) but dyspnea burden is highly variable.

Objectives: Identify distinct profiles of dyspnea burden and identify predictors of dyspnea symptom profile.

Methods: A secondary analysis of data from five studies completed at Oregon Health and Science University was conducted. The Heart Failure Somatic Perception Scale was used to measure dyspnea burden. Latent class mixture modeling identified distinct profiles of dyspnea burden in a sample of HF patients (n = 449). Backwards stepwise multinomial logistic regression identified predictors of latent profile membership.

Results: Four profiles of dyspnea burden were identified: no dyspnea/not bothered by dyspnea, mild dyspnea, moderate exertional dyspnea, and moderate exertional dyspnea with orthopnea and PND. Higher age was associated with greater likelihood of not being bothered by dyspnea than having moderate exertional dyspnea with orthopnea and PND. Higher NYHA class, anxiety, and depression were associated with greater likelihood of greater dyspnea burden.

Conclusions: Burden of dyspnea is highly variable among HF patients. Clinicians should account for the nuances of dyspnea and the activities that induce dyspnea when assessing HF patients.

Keywords: Dyspnea; Heart failure; Latent class mixture modeling; Symptom burden.