Significance: Interoceptive accuracy (IA) is the objective accuracy in detecting internal bodily sensations. Among patients with heart failure (HF), increased IA might translate into greater ability to monitor HF symptoms and better self-care maintenance and management. The heartbeat tracking test (HTT), a validated objective interoception measure, assesses the ability to accurately perceive heartbeats. In past studies, patients have accurately perceived between 55% to 82% of their heartbeats. However, there is limited research utilizing HTT to measure IA among individuals with HF, and no studies have assessed the association between HTT and HF self-care.

Methods: Participants were a subsample of 48 adults with a confirmed diagnosis of HF and mild cognitive impairment (MCI) (scores 15-26 on MoCA) participating in an ongoing randomized controlled trial. At baseline, participants completed assessments of IA (HTT) and HF self-care (Self-Care Heart Failure Index, SCHFI). The IA score was calculated as the average proportion of perceived to actual heartbeats over three trials. Participants were then grouped as follows: 1) no IA (0 heartbeats perceived), 2) low IA (scores at or below the median), 3) high IA (scores above the median). We conducted three separate linear regression models with IA group as predictors and the three SCHFI scales (self-care maintenance, self-care monitoring, self-care management) as outcomes, controlling for age and education level.

Results: The average age of participants was 73 years (SD = 11.3). Most (52.1%) were female and White (79.2%). The average HTT score was 0.35 (accurately perceiving 35% of heartbeats) (SD = 0.31), with 29% in the no IA group (no heartbeats perceived), 19% in the low IA group (at or below the median), and 50% in the high IA group (above the median). There were no significant relationships between IA group and self-care maintenance or monitoring. Higher HTT group was associated with greater self-care management (β = 2.37, 95% CI = 0.14, 4.61, p = .04).

Conclusions: In this sample of individuals with co-morbid HF and MCI, the average HTT score was low, indicating that individuals with HF have low interoceptive accuracy. However, higher IA was associated with greater self-care management. Higher IA may motivate patients with HF and MCI to take action when experiencing symptoms.