Heart Failure Severity in Relation to Kyphosis, Chest Expansion, Muscle Strength, and Nutrition

Background and Purpose: Heart failure (HF) is a progressive condition affecting cardiac, musculoskeletal, and nutritional systems. As disease severity advances, people often develop physical deconditioning, postural alterations, and respiratory limitations. This study aimed to investigate the relationship between HF severity and thoracic kyphosis, chest expansion, muscle strength, and nutritional status. Methods: A cross-sectional study was conducted on 63 participants with HF aged 18 to 80 years, classified based on the New York Heart Association scale. After a brief demographic, chief complaint and occupational activity level assessment, thoracic kyphosis was measured using a Flexicurve, chest expansion with an inelastic tape, muscle strength via the 30-second Chair Stand Test, and nutritional status using the Mini Nutritional Assessment—Short Form. Results: Heart failure severity showed a moderate negative correlation with chest expansion at the axillary level (r = −0.414, P = .001) and with trunk and lower limb strength (r = −0.310, P = .013). No significant correlation was found with thoracic kyphosis, chest expansion at nipple or xiphisternal levels, or nutritional status. Discussion: This trend is reflective of the disease burden itself, as HF often leads to exercise intolerance, fatigue, and dyspnea, which limit the capacity for physically demanding work. Conclusion: Increasing HF severity is associated with reduced upper chest expansion and muscle strength, whereas postural alignment and nutritional status remain largely unaffected. These findings highlight the importance of incorporating targeted assessments and interventions for upper thoracic mobility and muscle strength in HF management.