A Study of Pulmonary Congestion and Patient-reported Outcomes in Heart Failure (MONITOR - HF)

项目摘要 心力衰竭(HF)是美国增长最快的心血管疾病，目前仍是 与高发病率和高死亡率有关。对症状的识别是诊断和治疗的关键因素 治疗心力衰竭，因为症状是住院和健康相关生活质量的关键驱动因素 (HRQOL)。我们预测谁将经历更沉重的症状的能力因缺乏 心功能客观指标与症状的相关性。我们对HF认识上的一个重大差距 症状生物学是指肺充血--心力衰竭病理生理的客观指标--与心力衰竭的关系。 症状、自我管理行为和HRQOL。因此，这项研究的总体目标是 确定临床使用的设备检测到的肺充血的关联 心力衰竭的治疗和自我管理在心力衰竭患者中的作用 缓和设备检测到的拥塞、症状和生活质量之间的关系。聘用一名 纵向设计和集成从植入的除颤器/起搏器远程下载的数据和 通过对60名有症状的成人心衰队列的调查收集的数据，我们将解决两个具体目标：1) 量化设备检测到的拥塞与HF症状和HRQOL之间的关联和2) 确定HF自助管理对设备检测到的拥塞之间关系的影响 心衰症状和HRQOL。这项创新的研究将是第一次考察 肺充血和体力衰竭症状及首先确定患者自我护理的作用 协调设备检测到的拥塞、HRQOL和症状之间的关系的管理 高频。此外，作为一项由国家研究服务奖支持的研究提案，这项研究将 帮助申请人发展成为一名独立的护士科学家，拥有一个有影响力的项目 重点研究心衰症状的生物学和行为学基础。拟议的学习和培训 计划整合了一支成熟的跨学科团队的临床和分析专业知识。这 拟议的奖学金研究和培训计划与国家研究所的使命和目标很好地保持一致 从症状生物学、自我管理行为及其发展谈护理研究 有影响力和独立的护士科学家。

Project Summary Heart failure (HF) is the fastest growing cardiovascular disorder in the United States and continues to be associated with high morbidity and mortality. Recognition of symptoms is a critical factor in the diagnosis and treatment of HF because symptoms are key drivers of hospitalizations and health-related quality of life (HRQOL). Our ability to predict who will experience more burdensome symptoms is hindered by the lack of association between objective markers of heart function and symptoms. A critical gap in our knowledge of HF symptom biology is how pulmonary congestion, an objective measure of HF pathophysiology, is related to HF symptoms, self-management behaviors and HRQOL. Accordingly, the overall goals of this study is to determine the association of pulmonary congestion that is detected by devices used in the clinical management of HF with physical symptoms of HF and HRQOL and to examine the role of self-management in moderating the relationship between device-detected congestion, symptoms and quality of life. Employing a longitudinal design and integrating data remotely downloaded from implanted defibrillator/pacemakers and data collected via survey in a cohort of 60 adults with symptomatic HF, we will address two specific aims: 1) quantify the association between device-detected congestion with both HF symptoms and HRQOL and 2) determine the influence of HF self-care management on the relationship between device-detected congestion and HF symptoms and HRQOL. This innovative study will be the first to examine associations between pulmonary congestion and physical HF symptoms and the first to determine the role of patient self-care management in moderating the relationship between device-detected congestion, HRQOL and symptoms of HF. Furthermore, as a research proposal supported by a National Research Service Award, this study will contribute to the development of the applicant into an independent nurse scientist with an influential program of study focusing on biological and behavioral foundations of HF symptoms. The proposed study and training plan integrate the combined clinical and analytic expertise of a well-established interdisciplinary team. This proposed fellowship research and training plan is well-aligned with the mission and goals of National Institute of Nursing Research through the focus on symptom biology, self-management behaviors, and the development of influential and independent nurse scientists.