Fatigue with systolic heart failure

J Cardiovasc Nurs. Sep-Oct 2009;24(5):410-7. doi: 10.1097/JCN.0b013e3181ae1e84.


Background and research objective: Fatigue is one of the most prevalent symptoms in persons with systolic heart failure (HF). There remains insufficient information about the physiological and psychosocial underpinnings of fatigue in HF. The specific aims of this study were to (1) determine the psychometric properties of 2 fatigue questionnaires in patients with HF, (2) compare fatigue in patients with HF to published scores of healthy adults and patients with cancer undergoing treatment, and (3) identify the physiological (eg, hemoglobin, B-type natriuretic peptide, body mass index, and ejection fraction) and psychosocial (eg, depressed mood) correlates of fatigue in HF.

Subjects and methods: A convenience sample of 87 HF outpatients was recruited from 2 urban medical centers. Patients completed the Fatigue Symptom Inventory, Profile of Mood States, and Short Form-36 Health Survey.

Results and conclusions: Patients with HF and patients with cancer reported similar levels of fatigue, and both patient groups reported significantly more fatigue than did healthy adults. Physical functioning and hemoglobin categories explained 30% of the variance in Fatigue Symptom Inventory-Interference Scale scores, whereas depressed mood and physical functioning explained 47% of the variance in Profile of Mood States Fatigue subscale scores. Patients with HF experienced substantial fatigue that is comparable with cancer-related fatigue. Low physical functioning, depressed mood, and low hemoglobin level were associated with HF-related fatigue.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Anemia / blood
  • Anemia / complications
  • Case-Control Studies
  • Cross-Sectional Studies
  • Depressive Disorder / complications
  • Fatigue / diagnosis*
  • Fatigue / epidemiology
  • Fatigue / etiology*
  • Female
  • Heart Failure, Systolic / complications*
  • Heart Failure, Systolic / metabolism
  • Heart Failure, Systolic / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Neoplasms / complications
  • Prevalence
  • Prospective Studies
  • Psychometrics
  • Regression Analysis
  • Risk Factors
  • Severity of Illness Index*
  • Surveys and Questionnaires / standards*


  • Natriuretic Peptide, Brain