UC Davis

Background

The relationship between physical and affective symptom clusters in heart failure (HF) is unclear.

Objectives

To identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups.

Methods

This was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively.

Results

In this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival.

Conclusion

Congruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.