Fatigue and Cytokines with Heart Failure

描述(申请人提供)：本护理科学研究计划的长期目标是描述与收缩性心力衰竭(HF)男性和女性疲劳症状相关的生理、心理和行为因素。这项研究产生的数据将作为制定干预措施的基础，以管理疲劳并提高这一人群的生活质量。这项研究的主要目的是：描述和比较收缩性心力衰竭患者和年龄匹配的健康对照组之间的疲劳症状(疲劳严重程度指数、情绪状态特征和简明36健康调查)，确定抑郁(医院焦虑和抑郁量表)等心理社会因素是否与心力衰竭患者的疲劳相关，以及确定细胞因子(组织坏死因子α和白介素6，用酶联免疫分析法测定)水平升高是否与心力衰竭患者的疲劳相关。申请人假设，在患有收缩期心衰的男性和女性中，促炎症细胞因子水平的增加和抑郁与疲劳的发生有关。促炎性细胞因子(组织坏死因子α、白介素6)与心力衰竭患者的疲劳有关，但据作者所知，尚未发表细胞因子与心力衰竭患者自我报告的疲劳程度相关的研究。建议的研究将采用前瞻性、横断面研究设计。一个方便的样本将从一个大型的城市心力衰竭门诊环境中招募。受试者年龄在45岁或以上，将根据体检和诊断测试被诊断为收缩期心衰，这些检查显示左心室射血分数为40%，并被归类为NYHA II-IV级。所有受试者将在委员会认证的心脏病专家的照顾下，年龄在45岁或以上。年龄匹配的男性和女性受试者将从社区环境中招募作为对照组。HF和对照组受试者将完成疲劳严重程度指数、情绪状态概况、简表36健康调查，并将在两个时间点(基线和6-8天后)提供血样用于细胞因子分析。这项研究与公共卫生的相关性非常高。心力衰竭是美国最常见的心血管疾病之一，而疲劳是与心力衰竭相关的最令人虚弱的症状。这项拟议研究的结果将有助于开发未来的干预措施来管理心力衰竭患者的疲劳。

DESCRIPTION (provided by applicant): The long-term objective of this nursing science research program is to describe the physiological, psychological, and behavioral factors associated with the symptom of fatigue in men and women with systolic heart failure (HF). Data generated from this study will serve as the foundation for the development of interventions to manage fatigue and improve quality of life in this population. The primary aims of the study are: 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-matched healthy control subjects, to determine if psychosocial factors such as depression (Hospital Anxiety and Depression Scale) are correlated to fatigue in HF patients, and to determine if increased levels of the cytokines (tissue necrosis factor alpha and interleukin-6, as determined by enzyme-linked immunoassay) are correlated to fatigue in HF patients. The applicant hypothesizes that in men and women with systolic HF, increased levels of proinflammatory cytokines and depression are correlated to the occurrence of fatigue. Proinflammatory cytokines (tissue necrosis factor alpha, interleukin-6) have been implicated in fatigue in HF, but to the author's knowledge, no studies have been published in which cytokines were correlated with self reported measures of fatigue from HF patients. The proposed research will utilize a prospective, cross-sectional study design. A convenience sample will be recruited from a large urban based heart failure outpatient setting. Subjects will be 45 years of age or older and will be diagnosed with systolic HF based on physical exam and diagnostic tests, which reveal a left ventricular ejection fraction of < 40%, and are assigned to NYHA classification II-IV. All subjects will be under the care of a board certified cardiologist and will be 45 years of age or older. Age-matched male and female subjects will be recruited from a community setting to serve as a control group. HF and control subjects will complete the Fatigue Severity Index, Profile of Mood States, Short Form 36 Health Survey, and will provide blood samples for cytokine analysis at two time points (baseline and 6-8 days later). The relevance of this research to public health is very high. HF is one of the most prevalent cardiovascular disorders in the U.S., and fatigue is the most debilitating symptom associated with HF. Findings from the proposed study will contribute to the development of future interventions to manage fatigue in HF patients.