Knowledge Domain and Emerging Trends in Heart Failure and Anxiety Comorbidity: A Scientometric Analysis.

Objective: The high prevalence of anxiety disorders among heart failure (HF) patients significantly impacts clinical outcomes, yet a comprehensive analysis of the global research landscape is lacking. This study explores research trends, knowledge structure, and emerging hotspots in the field of HF and anxiety comorbidity over the past decade. Methods: A bibliometric analysis was conducted on 1,475 publications from the Web of Science Core Collection (2015-2024). A total of 1,475 English-language publications, including articles and reviews, were analyzed. CiteSpace and VOSviewer were used to analyze collaboration networks, references, and keywords. The search tool for the retrieval of interacting genes database was applied to construct a protein-protein interaction (PPI) network of HF and anxiety comorbidity. R with clusterProfiler was applied to perform kyoto encyclopedia of genes and genomes pathway enrichment analysis. Cytoscape was applied to visualize both the PPI network and the significant pathways. Results: Annual publications increased steadily, peaking in 2021. The United States of America and China emerged as the most productive countries. Key contributors included Linkoping University and Harvard Medical School. Keyword analysis revealed evolving focuses from mortality and depression to self-care, cardiac rehabilitation, and psychological assessment tools. Gene intersection analysis identified 124 shared genes, with hub genes such as AKT1, TP53, and IL6 implicated in MAPK, FoxO, and JAK-STAT signaling pathways. These results suggest neuroendocrine and inflammatory mechanisms linking HF and anxiety. Conclusion: This study offers the bibliometric and molecular insight into the HF and anxiety comorbidity landscape. While research output and mechanistic understanding have grown, gaps remain in standardized assessment and clinical translation. Future studies should focus on translating these mechanistic insights into strategies that improve integrated care and quality of life for patients living with the dual burden of heart failure and anxiety.