Symptoms of fatigue in chronic heart failure patients: Clinical and psychological predictors

Abstract

To examine the role of clinical and psychological characteristics as predictors of fatigue in CHF. Little is known about predictors of fatigue in CHF. Next to heart failure characteristics, depressive symptoms and type-D personality may explain individual differences in fatigue. At baseline, 136 CHF outpatients (age<or=80 years) completed a questionnaire to assess depressive symptoms, type-D personality and cardiac symptoms. At one-year follow-up, they completed the Dutch Exertion Fatigue Scale and the Fatigue Assessment Scale to assess symptoms of fatigue. Medical information was obtained from the patients' medical records. Exertion fatigue and general fatigue were identified as different manifestations of fatigue. We found that exertion fatigue at 12-month follow-up was predicted by decreased exercise capacity (beta=-.35; p<.001), dyspnoea (beta=24; p=.002), hypertension (beta=.16; p=.03), and depressive symptoms (beta=.16; p=.05). In contrast, general fatigue at 12-month follow-up was predicted by dyspnoea (beta=.24; p=.003), depressive symptoms (beta=.27; p<.001), type-D personality (beta=17; p=.03), and sleep problems (beta=.20; p=.01). Together, these variables explained 32% and 37% of the variance, respectively. The present study showed that fatigue was related to both clinical and psychological characteristics. The use of this knowledge may lead to a better understanding and treatment of the clinical manifestations of fatigue in CHF.