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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