Fatigue and Cytokines with Heart Failure

描述（由申请人提供）：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。本研究产生的数据将作为开发干预措施的基础，以管理疲劳和改善该人群的生活质量。研究的主要目的是：描述和比较疲劳的症状在收缩性心力衰竭患者和年龄匹配的健康对照受试者之间进行疲劳严重程度指数、情绪状态特征和简明健康调查表36，以确定是否存在心理社会因素，如抑郁症，（医院焦虑和抑郁量表）与HF患者的疲劳相关，并确定是否增加了细胞因子水平，（组织坏死因子α和白细胞介素-6，通过酶联免疫测定）与HF患者的疲劳相关。申请人假设，在患有收缩期HF的男性和女性中，促炎细胞因子水平升高和抑郁与疲劳的发生相关。促炎细胞因子（组织坏死因子α、白细胞介素-6）与HF患者的疲劳有关，但据作者所知，尚未发表细胞因子与HF患者自我报告的疲劳测量相关的研究。拟议的研究将采用前瞻性、横断面研究设计。将从大型城市心力衰竭门诊环境中招募便利样本。受试者将为45岁或以上，并且将基于身体检查和诊断测试被诊断为患有收缩期HF，其显示左心室射血分数<40%，并且被分配为NYHA分级II-IV。所有受试者将接受委员会认证的心脏病专家的护理，年龄为45岁或以上。将从社区环境中招募匹配的男性和女性受试者作为对照组。HF和对照受试者将完成疲劳严重程度指数、情绪状态特征、简表36健康调查，并将在两个时间点（基线和6-8天后）提供用于细胞因子分析的血液样本。这项研究与公共卫生的相关性非常高。HF是美国最普遍的心血管疾病之一，并且疲劳是与HF相关的最使人衰弱的症状。拟议研究的结果将有助于未来开发管理HF患者疲劳的干预措施。

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.