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 <
.002). 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.