Key result
Fatigue, exertional dyspnea, and anxiety emerge as core hubs driving symptom burden in chronic HF.
Why the study?
The composition characteristics and core symptom network structure of symptom clusters in patients with chronic heart failure during cardiac rehabilitation were not well defined to guide precise symptom management.
Cross-Sectional (n=550)
No
In patients with chronic heart failure undergoing cardiac rehabilitation, fatigue, shortness of breath, and anxiety function as the central interconnected symptoms, highlighting them as prioritized targets for multidimensional interventions.
Answers are grounded in this paper and cite their sources.
May prioritize fatigue, dyspnea, and anxiety in HF rehab symptom management; hypothesis-generating for network-targeted interventions pending prospective trials.
This study investigates the composition characteristics of symptom clusters in patients with chronic heart failure (CHF) during the cardiac rehabilitation phase, constructs their symptom network structure, and identifies core symptoms, thereby providing a foundation for optimizing the precise management plan for symptoms during the rehabilitation period. A convenience sampling method was employed. From January 2023 to May 2025, 550 patients with CHF undergoing cardiac rehabilitation at the Department of Cardiology of Nantong Sixth People's Hospital were selected for a cross-sectional survey. The patients' symptom experiences were assessed using a general information questionnaire and the Chinese version of the Memorial Heart Failure Symptom Assessment Scale for Heart Failure. The analysis primarily focused on the degree of symptom distress, and exploratory factor analysis was conducted to extract symptom clusters. The R 4.3.1 software was utilized to construct a symptom network model, and node strength and closeness centrality were calculated to identify core symptoms and their interrelationships. The identification of symptom clusters through exploratory factor analysis revealed 5 distinct clusters that accounted for 63.75% of the variance. These clusters include: cardiopulmonary function limitation, fluid retention imbalance, fatigue-nutritional disorder, gastrointestinal symptoms, and neuropsychological disorders. Notably, shortness of breath following activity (r_s = 4.618), fatigue (r_s = 4.752), and anxiety (r_s = 4.752) emerged as the core hubs of the network, with fatigue exhibiting a predictability of up to 69%. Medical staff should prioritize intervening in the 3 core symptoms, paying attention to their cross-group correlations, and implementing precise management strategies based on the symptom network structure to effectively reduce the symptom burden during the recovery period, promote functional recovery, and improve the quality of life.
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Zhang et al. (2025) conducted a cross-sectional in Chronic heart failure (CHF) in the cardiac rehabilitation phase (n=550). Chronic heart failure during stable cardiac rehabilitation was evaluated on Symptom network core hubs (node strength rs). Symptom network analysis of patients with chronic heart failure undergoing cardiac rehabilitation identified fatigue (rs = 4.752), shortness of breath after activity (rs = 4.618), and anxiety (rs = 4.302) as the core hubs driving symptom burden.
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