Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Biol Res Nurs. 2024 Jul;26(3):350-360. doi: 10.1177/10998004231225442. Epub 2024 Jan 2.
Atrial fibrillation (AF) is a common cardiac arrhythmia affecting over 6 million people in the U.S. Fatigue is a frequent symptom of AF, yet no underlying biological mechanisms have been identified in AF-related fatigue as in other chronic conditions such as cancer or HIV fatigue (inflammation, tissue injury). We aimed to identify biomarkers and correlates of AF-fatigue in ARIC participants.
Participants with AF from ARIC visit 5 (2011-2013) were included in the study. Multiple linear regression was used to estimate the association of high sensitivity troponin (hs-TnT), N-terminal fragment B-type natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hsCRP) levels with self-reported fatigue (SF-12 and PROMIS Fatigue Scale), depressive symptoms (Center for Epidemiological Studies Depression survey), and physical functioning (Short Physical Performance Battery) scores. All biomarkers underwent natural-log transformation.
There were 446 participants (mean age: 78 y ± 5; 44% women). In adjusted analyses, NT-proBNP was associated with AF-fatigue (β: 0.11, 95% CI: 0.03, 0.19), increased depressive symptoms (β: 0.44, 95% CI: 0.19, 0.70), and decreased physical function (β: -0.48, 95% CI: -0.72, -0.23). Hs-TnT was also associated with elevated AF-fatigue (β: 0.24, 95% CI: 0.09, 0.39) along with decreased physical function (β: -1.19, 95% CI: -1.64, -0.75). No significant associations were found with hsCRP and fatigue.
Increased levels of cardiac injury biomarkers, depressive symptoms, and decreased physical function were associated with AF-fatigue. Inflammation was not associated with AF-fatigue; other physiological pathways, such as cardiac overload or myocardial injury may be more relevant in AF-fatigue.
心房颤动（AF）是一种常见的心律失常，影响了美国超过 600 万人。疲劳是 AF 的常见症状，但与其他慢性疾病（如癌症或 HIV 疲劳）不同，尚未确定与 AF 相关的疲劳的潜在生物学机制（炎症、组织损伤）。我们旨在确定 ARIC 参与者中与 AF 相关的疲劳的生物标志物和相关性。
从 ARIC 访问 5（2011-2013 年）中纳入患有 AF 的参与者。使用多元线性回归来估计高敏肌钙蛋白（hs-TnT）、N 末端片段 B 型利钠肽（NT-proBNP）和高敏 C 反应蛋白（hsCRP）水平与自我报告的疲劳（SF-12 和 PROMIS 疲劳量表）、抑郁症状（流行病学研究抑郁调查）和身体功能（简短身体表现电池）评分之间的关联。所有生物标志物均经过自然对数转换。
共有 446 名参与者（平均年龄：78 岁±5；44%为女性）。在调整分析中，NT-proBNP 与 AF 相关的疲劳（β：0.11，95%CI：0.03，0.19）、抑郁症状增加（β：0.44，95%CI：0.19，0.70）和身体功能下降（β：-0.48，95%CI：-0.72，-0.23）相关。hs-TnT 也与升高的 AF 相关的疲劳（β：0.24，95%CI：0.09，0.39）以及身体功能下降（β：-1.19，95%CI：-1.64，-0.75）相关。hsCRP 与疲劳无显著相关性。
心脏损伤生物标志物水平升高、抑郁症状和身体功能下降与 AF 相关的疲劳相关。炎症与 AF 相关的疲劳无关；其他生理途径，如心脏负荷过重或心肌损伤，可能与 AF 相关的疲劳更为相关。
