Introduction: Fatigue is a prevalent symptom burden in heart failure (HF) patients, negatively
affecting quality of life (QOL) and prognosis. However, the state of fatigue in HF
patients remains unclear. Methods: We conducted a systematic review by entering the following keywords into four search
engines (“heart failure” or “ventricular dysfunction”) and (“fatigue” or “tiredness”
or “exhaustion” or “lack of energy”). Results: One hundred six studies were selected for analysis, including seven qualitative studies.
To describe “fatigue”, 86 studies used the term fatigue, 11 used tiredness, 11 used
lack of energy, and five used vital exhaustion. Fatigue was experienced in 30% to
96% of all HF patients, and their symptom burden was more severe than that of the
general population. Fatigue was expressed as a subjective experience with decreased
physical and mental status. Additionally, fatigue was associated with increase in
cardiac readmission and mortality rate, low QOL, poor self-care and consulting behavior.
Fatigue was significantly predicted by comorbidities, severity of HF, physical capacity,
several symptoms including dyspnea and pain, psychological distress and sense of coherence.
Conclusions: Fatigue in HF patients is a multidimensional and complex symptom that is affected
by several factors. To reduce symptom burden due to fatigue, further research is needed.
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