UT Southwestern Medical Center cardiologists have defined a novel heart failure symptom in advanced heart failure patients: shortness of breath while bending over, such as when putting on shoes.
The condition, which UT Southwestern cardiologists named "bendopnea" (pronounced "bend-op-nee-ah"), is an easily detectable symptom that can help doctors diagnose excessive fluid retention in patients with heart failure, according to the findings published in a recent edition of the Journal of the American College of Cardiology: Heart Failure.
"Some patients thought they were short of breath because they were out of shape or overweight, but we wondered if there was something more to it. So we developed this study to further investigate this symptom," said Dr. Jennifer Thibodeau, Assistant Professor of Internal Medicine in the Division of Cardiology.
Dr. Thibodeau cautions that bendopnea is not a risk factor for heart failure, but rather a symptom that heart failure patients are becoming sicker and may need to have their medications or treatments adjusted.
Bendopnea is a way for both doctors and patients to recognize something may be amiss with their current heart failure treatment. Patients should speak with their cardiologist or health care provider if they experience bendopnea, notes Dr. Thibodeau.
Of the 5.7 million Americans living with heart failure, about 10 percent have advanced heart failure, according to the American Heart Association. The condition is considered advanced when conventional heart therapies and symptom management strategies no longer work.
UT Southwestern doctors enrolled 102 patients who were referred to the cardiac catheterization lab for right heart catheterization and found that nearly one-third of the subjects had bendopnea.
When the patients were lying flat, clinicians measured both the pressures within the heart as well as the cardiac output -- how well the heart is pumping blood to the rest of the body -- in all 102 patients. Then, they repeated these measurements in 65 patients after they were sitting in a chair for two minutes, and then bending over for one minute.
"We discovered that patients with bendopnea had too much fluid in their bodies, causing elevated pressures, and when they bent forward, these pressures increased even more," said Dr. Thibodeau, first author of the study.
- Jennifer T. Thibodeau, Aslan T. Turer, Sarah K. Gualano, Colby R. Ayers, Mariella Velez-Martinez, Joseph D. Mishkin, Parag C. Patel, Pradeep P.A. Mammen, David W. Markham, Benjamin D. Levine, Mark H. Drazner. Characterization of a Novel Symptom of Advanced Heart Failure: Bendopnea. JACC: Heart Failure, 2014; 2 (1): 24 DOI: 10.1016/j.jchf.2013.07.009
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