Background Black adults face a higher prevalence of heart failure (HF), with greater symptom burden and earlier onset compared to other populations. Systemic inflammation and socioeconomic factors, including neighborhood deprivation, contribute to these disparities. Understanding the interplay between inflammation, HF symptoms, and social determinants of health is critical for addressing inequities in HF outcomes.

Objectives This study examines associations between inflammatory biomarkers and physical and psychological symptoms in Black adults with HF and explores the impact of neighborhood deprivation on these factors.

Methods Black adults with HF (N=41) were enrolled in this cross-sectional study. Blood samples were collected using Mitra Microsampling for biomarker analysis, including cytokines, chemokines, and xanthine oxidase (XO) activity. Symptoms were assessed using validated measures for dyspnea, fatigue, anxiety, depression, stress, and sleep disturbance. Neighborhood deprivation was evaluated using the Area Deprivation Index.

Results Elevated XO activity was significantly associated with dyspnea severity (β = 0.75, p < .001). Chemokines linked to T cell activation (e.g., C-C motif ligand[CCL]-11, CXC motif ligand[CXCL]-8) correlated with HF symptoms and psychological distress, including anxiety and perceived stress. Higher neighborhood deprivation scores were associated with increased stress, sleep disturbance, and inflammatory biomarkers (e.g., interleukin[IL]-4, vascular cell adhesion molecule[VCAM]-1).

Conclusions This study highlights the role of inflammation and neighborhood deprivation in HF symptomatology among Black adults. Targeting oxidative stress and inflammatory pathways, alongside addressing social determinants of health, may reduce symptom burden and improve outcomes in this population.

The authors have declared no competing interest.

The study was supported in part by the National Institutes of Health grant numbers P30NR018090 and U54AG062334. Effort for this work was supported by National Institutes of Health grant numbers K23AG076977 (Butts) and T32NR012715 (Herring). The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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IRB of Emory University gave ethical approval for this work.

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