Background

Patients with chronic heart failure often experience symptoms during physical activity, such as shortness of breath and tachycardia, which may result in fear of physical activity (FoPA). This study tested whether interoception (i.e., the perception of body sensations) and symptom distress (i.e., negative appraisal of symptoms) are associated with FoPA in outpatients with chronic heart failure.

Method

FoPA was assessed with the Fear of Activities in Situations (FActS) in patients with diagnosed heart failure and healthy controls. A heartbeat tracking task and self-reports were used to assess interoceptive accuracy and interoceptive attention in patients and controls. Heart failure-related distress was assessed using ratings of symptom and treatment burden in patients. Multiple regression models were calculated to determine associations with continuous FoPA scores.

Results

Patients with low FoPA perceived their heartbeats more accurately than patients with high FoPA and healthy controls. Interoceptive accuracy and symptom distress explained almost half of the variance in FoPA, after adjustments for sex and disease severity, in patients with heart failure.

Conclusions

In patients inaccurate interoception and symptom distress were associated with high FoPA, independent of heart failure severity. The perception and appraisal of cardiac arousal and symptoms during physical activity deserve further attention to develop interventions to reduce FoPA in patients with heart failure.

ClinicalTrials.gov Identifier

NCT03119298.

中文翻译：

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对体力活动的恐惧与慢性心力衰竭患者的心脏内感受和症状困扰有关

背景

慢性心力衰竭患者在体力活动期间经常会出现呼吸短促和心动过速等症状，这可能会导致对体力活动的恐惧（FoPA）。这项研究测试了慢性心力衰竭门诊患者的内感受（即身体感觉的感知）和症状困扰（即对症状的负面评价）是否与 FoPA 相关。

方法

FoPA 通过对情境活动的恐惧 (FActS) 对诊断为心力衰竭的患者和健康对照进行评估。使用心跳跟踪任务和自我报告来评估患者和对照组的内感受准确性和内感受注意力。使用患者症状和治疗负担的评级来评估心力衰竭相关的痛苦。计算多元回归模型以确定与连续 FoPA 评分的关联。

结果

FoPA 较低的患者比 FoPA 高的患者和健康对照者更能准确地感知自己的心跳。在调整性别和疾病严重程度后，心力衰竭患者的 FoPA 变异几乎有一半是由内感受准确性和症状困扰解释的。

结论

在患者中，不准确的内感受和症状困扰与高 FoPA 相关，与心力衰竭的严重程度无关。体力活动期间心脏唤醒和症状的感知和评估值得进一步关注，以制定干预措施以减少心力衰竭患者的 FoPA。

ClinicalTrials.gov 标识符

NCT03119298。