Heart failure has been called the most important public health problem facing cardiovascular clinicians and researchers because of its high and increasing incidence, prevalence, morbidity and mortality. Despite substantial advances in pharmacologic therapy made in recent years, clinical improvements seen among patients are relatively modest and quality of life often remains poor. Nonpharmacologic therapy has received relatively little attention, yet has potential to serve as an important adjunct to pharmacologic therapy. Biofeedback-relaxation, a cognitive biobehavioral nonpharmacologic intervention, has been demonstrated to be effective in conditions with pathophysiological and psychological manifestations of heart failure. Accordingly, specific aims of this project are to determine the impact of biofeedback-relaxation training on 1) the combined primary end-point of heart failure rehospitalizations or cardiac mortality, 2) quality of life; 3) intermediate (mediating) patient outcomes of perceived control, anxiety and depression, and 4) intermediate (mediating) physiologic outcomes of finger and foot skin temperature, heart rate variability and plasma norepinephrine. We hypothesize that biofeedback-relaxation training will result in decreased heart failure rehospitalizations or cardiac death, improved quality of life, increased perceived control, decreased anxiety and depression, increased finger and foot temperature, improved heart rate variability, and decreased plasma norepinephrine. To test these hypotheses, 420 patients with advanced heart failure will be randomized to one of three groups: 1) biofeedback-relaxation (intervention); 2) sham biofeedback-relaxation (placebo-control); or 3) usual care control. Within these groups, patients will be stratified such that each group will include 50% taking and 50% not taking angiotensin converting enzyme inhibitors. Data will be collected at baseline, 3, and 12 months and will be analyzed using survival analyses and repeated measure ANOVA. Biofeedback-relaxation training for patients with heart failure may have potential long-term clinical benefits and may serve as an important adjunct to pharmacologic therapy. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR008567-04
Application #
7187384
Study Section
Nursing Science: Adults and Older Adults Study Section (NSAA)
Program Officer
Huss, Karen
Project Start
2004-06-01
Project End
2009-02-28
Budget Start
2007-03-01
Budget End
2008-02-29
Support Year
4
Fiscal Year
2007
Total Cost
$304,485
Indirect Cost
Name
University of Kentucky
Department
Type
Schools of Nursing
DUNS #
939017877
City
Lexington
State
KY
Country
United States
Zip Code
40506
Alhurani, Abdullah S; Dekker, Rebecca; Ahmad, Muayyad et al. (2018) Stress, cognitive appraisal, coping, and event free survival in patients with heart failure. Heart Lung 47:205-210
Saleh, Zyad T; Wu, Jia-Rong; Salami, Ibrahim et al. (2018) The Association Between Depressive Symptoms and N-Terminal Pro-B-Type Natriuretic Peptide With Functional Status in Patients With Heart Failure. J Cardiovasc Nurs 33:378-383
Lee, Kyoung Suk; Lennie, Terry A; Yoon, Ju Young et al. (2017) Living Arrangements Modify the Relationship Between Depressive Symptoms and Self-care in Patients With Heart Failure. J Cardiovasc Nurs 32:171-179
Wierenga, Kelly L; Dekker, Rebecca L; Lennie, Terry A et al. (2017) African American Race Is Associated With Poorer Outcomes in Heart Failure Patients. West J Nurs Res 39:524-538
Lee, Kyoung Suk; Lennie, Terry A; Heo, Seongkum et al. (2016) Prognostic Importance of Sleep Quality in Patients With Heart Failure. Am J Crit Care 25:516-525
Wu, Jia-Rong; Lennie, Terry A; Frazier, Susan K et al. (2016) Health-Related Quality of Life, Functional Status, and Cardiac Event-Free Survival in Patients With Heart Failure. J Cardiovasc Nurs 31:236-44
Roser, Lynn P; Hall, Lynne A; Moser, Debra A (2016) Psychometric Properties of the Brief Symptom Inventory Hostility Subscale in Patients With Heart Failure. J Nurs Meas 24:162-175
Reeves, Geri C; Alhurani, Abdullah S; Frazier, Susan K et al. (2015) The association of comorbid diabetes mellitus and symptoms of depression with all-cause mortality and cardiac rehospitalization in patients with heart failure. BMJ Open Diabetes Res Care 3:e000077
Chung, Misook Lee; Lennie, Terry A; Mudd-Martin, Gia et al. (2015) Adherence to a low-sodium diet in patients with heart failure is best when family members also follow the diet: a multicenter observational study. J Cardiovasc Nurs 30:44-50
Alhurani, Abdullah S; Dekker, Rebecca L; Abed, Mona A et al. (2015) The association of co-morbid symptoms of depression and anxiety with all-cause mortality and cardiac rehospitalization in patients with heart failure. Psychosomatics 56:371-80

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