Impact of reduced ejection fraction on affect, cognition and self-care behaviors in adults with heart failure
Bibliographic record
Abstract
Abstract Introduction In response to the escalating complexity of clinical care for individuals with heart failure, there is a growing need for in-depth investigations. This study investigated the influence of ejection fraction (EF) on affective symptoms (i.e. anxiety and depression), cognitive function, and self-care behaviors in adults with heart failure. Aim The primary aim of this study was to compare affective symptoms, cognitive function and self-care behaviors between adults who had heart failure with reduced EF (HFrEF: EF≤40%) and adults who had heart failure with preserved EF (HFpEF: EF>40%). The secondary aim was to explore differences in the relationship between cognitive function and self-care behaviors. Material and Methods Participants in this cross-sectional study were recruited from heart failure clinics in Wroclaw, Poland between 2022 and 2023. Comprehensive clinical characteristics, including EF, were extracted from the medical record. Participants completed a survey that included reliable and valid measures of affective symptoms (Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire-9 (PHQ-9)), cognitive function (i.e. the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE)), and self-care behaviors (self-care of heart failure index). Results The study included a total of 250 participants with heart failure: 145 (58%) had HFrEF and 105 (42%) had HFpEF. Patients with HFrEF were younger (71.1±6.2 years) than those with HFpEF (73.0±7.0 years; p=0.011). There were fewer women with HFrEF (n=16 (15.2%)) than HFpEF (n=61 (42.1%); p<0.001). There were no statistically significant differences in affective symptoms, cognitive function or self-care behaviors comparing adults with HFrEF vs. HFpEF (all p>0.05). Overall, worse cognitive function was associated with worse self-care based on the MMSE (r=-0.20, p=0.001) but not the MoCA (r=-0.12, p=0.056). Conclusion Although there were no affective, cognitive, or self-care behavioral differences between adults with HFrEF and HFpEF, age and gender differences between these groups must be considered in clinical care. Additionally, cognitive dysfunction, especially as measured by the MMSE, must serve as a red flag for poor self-care in heart failure irrespective of EF.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".