Research

Anne Fink Funded Projects

Fatigue and Cytokines with Heart Failure

Funding Source: National Institute of Nursing Research, Pre-Doctoral Fellowship

Faculty Sponsors: Mariann Piano, Julie Zerwic

Dates: 6/16/08– 5/15/11

Abstract: Fatigue is one of the most prevalent and debilitating symptoms associated with heart failure (HF), restricting physical activity, diminishing quality of life, and predicting worsening of HF prognosis. Interestingly, patients’ reports of fatigue are rarely documented in medical records. Thus, HF patients receive inadequate consideration and treatment for their fatigue. To address such problems, the National Institutes of Health (NIH) Roadmap highlights the need to better quantify and address clinically important symptoms. Fatigue was specifically identified in the NIH Roadmap. Despite the prevalence of fatigue in HF patients, there remains limited knowledge about the description/characteristics of fatigue and the potential relationship to physiologic biomarkers (e.g., increased cytokine levels) and psychosocial factors (depression). Therefore, the following are the aims of this prospective study:

1) To describe and compare the symptom of fatigue (Fatigue Severity Index, Profile of Mood States, and Short Form 36 Health Survey) between patients with systolic heart failure and age, race, and gender matched control subjects.
2) To determine if psychosocial factors such as depression (Hospital Anxiety and Depression Scale) are correlated to fatigue in HF patients.
3) To determine if increased levels of the cytokines, tissue necrosis factor alpha (TNF alpha) and interleukin-6 (IL-6), are correlated to fatigue in HF patients.

It is hypothesized that in men and women with systolic HF, increased levels of proinflammatory cytokines (TNF alpha and IL-6) and depression are correlated with the occurrence of fatigue. In other chronic diseases, increases in cytokines have been implicated as biomarkers and/or causes of fatigue. Cytokines are also elevated in HF, but to this author’s knowledge, researchers have not examined the relationship between increased cytokine levels and self-reported measures of fatigue in HF patients. Also, in the setting of HF and fatigue, limited attention has been given to covariates, such as depression. The long-term goal of the research program is to describe the physiological, psychological, and behavioral factors associated with the symptom of fatigue in HF patients. Data generated from this study will serve as the foundation for the development of interventions to manage fatigue and improve quality of life for men and women with systolic HF.

Fatigue and Cytokines with Heart Failure

Funding Source: Midwest Nursing Research Society (MNRS)

Faculty Sponsor: Mariann Piano

Dates: 2/10/09– 2/10/10