Abstract 13986: Fatigue, Inflammation, and Projected Mortality in Heart Failure
Background: Fatigue is a prominent symptom of heart failure with reduced ejection fraction (HFrEF), but its pathophysiologic correlates remain unknown. The purpose of this study was to examine the relationships among fatigue, cytokines and projected mortality (Seattle Heart Failure Model [SHFM]) in HFrEF. We hypothesized that greater projected mortality would be associated with increased fatigue (Profile of Mood States [POMS-F]) and inflammatory biomarkers (tumor necrosis factor alpha [TNFα], interleukin-6 [IL-6], C-reactive protein [CRP]).
Methods: In this cross-sectional study we recruited control men and women (N = 25, age 61 ± 2 [SEM], 42% female) and HFrEF patients (N = 59, age 57 ± 2, 60% female). Subjects completed the POMS-F and provided venous blood to quantify TNFα, IL-6 (enzyme-linked immunoassay [R&D Systems]) and CRP (nephelometry [Quest Diagnostics]) in plasma.
Results: HFrEF patients had significantly greater fatigue (ρ < .001*); TNFα (ρ < .001*), IL-6 (ρ = .04*), and CRP (ρ < .001*); and body mass index (BMI, ρ = .02*) compared to controls (t tests). When controlling for BMI, however, only TNFα (but not IL-6 and CRP) levels were significantly elevated in HFrEF patients compared to controls (ANCOVA). HFrEF patients' SHFM scores were -1 (14%), 0 (49%) and 1 (37% [in order of increasing mortality risk]); BMI did not differ significantly among the SHFM groups. Higher SHFM scores were correlated with greater fatigue (r = .37, ρ = .01) and higher IL-6 (r = .42, ρ < .001).
Conclusion: Similar to others, we found significantly greater levels of fatigue and inflammatory biomarkers in HFrEF patients compared to controls. We are the first to report that increased IL-6 and CRP were related to greater BMI rather than to HFrEF and that fatigue was correlated with SHFM scores; the latter indicates that fatigue is associated with poorer prognosis in HFrEF.
- © 2011 by American Heart Association, Inc.