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

Objective: To examine the role of clinical and psychological characteristics as predictors of fatigue in CHF. Background: 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. Methods: At baseline, 136 CHF outpatients (age <= 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. Results: 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=.201- p=.01). Together, these variables explained 32% and 37% of the variance, respectively. Conclusion: 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. (C) 2007 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.