Ternrud Linda, Johansson Bengt, Sparv David, Mandalenakis Zacharias, Christersson Christina, Van Bulck Liesbet, Moons Philip, Sandberg Camilla, Hlebowicz Joanna
Department of Cardiology, Skåne University Hospital, Lund, Sweden.
Department of Clinical Science, Lund University, Sweden.
Int J Cardiol Congenit Heart Dis. 2025 Jun 16;21:100601. doi: 10.1016/j.ijcchd.2025.100601. eCollection 2025 Sep.
Fatigue is a symptom that has been described among adult patients with congenital heart disease (CHD) but the prevalence and impact of fatigue on the patient's daily life has been poorly studied. This study (i) examines the prevalence of fatigue in patients aged over 40 years with moderately complex or complex congenital heart disease compared to controls and (ii) explores the relationship between fatigue, heart disease complexity, clinical characteristics and self-reported New York Heart Association Functional Class (self-reported NYHA class).
The Multidimensional Fatigue Inventory (MFI-20) was applied in 166 patients with moderately complex CHD or complex CHD (44 % females, median age 55.3 years, IQR 47.6-64.8) along with 89 controls (43 % female, median age 54.0, IQR 46.0-65.9). MFI-20 measured general fatigue, physical fatigue, mental fatigue, reduced motivation and reduced activity.
Physical fatigue (severe to very severe) was more common in complex CHD compared with moderately complex CHD (25 % 52 %, = 0.006). Complex CHD was associated with severe to very severe physical fatigue (odds ratio 3.1 (95 % CI 1.1-9.1). Patients with complex CHD had higher levels of self-reported NYHA class than patients with moderately complex CHD. All dimensions of fatigue were positively associated with self-reported NYHA class.
Patients over the age of 40 with complex CHD were three times more likely to report severe to very severe physical fatigue and reported higher levels of self-reported NYHA class than patients with moderately complex CHD. This highlights the importance of considering CHD complexity in clinical practice.
疲劳是先天性心脏病（CHD）成年患者中出现的一种症状，但疲劳的患病率及其对患者日常生活的影响尚未得到充分研究。本研究（i）调查40岁以上中度复杂或复杂先天性心脏病患者与对照组相比疲劳的患病率，以及（ii）探讨疲劳、心脏病复杂性、临床特征与自我报告的纽约心脏协会心功能分级（自我报告的NYHA分级）之间的关系。
对166例中度复杂CHD或复杂CHD患者（44%为女性，中位年龄55.3岁，四分位间距47.6 - 64.8）和89例对照者（43%为女性，中位年龄54.0岁，四分位间距46.0 - 65.9）应用多维疲劳量表（MFI - 20）。MFI - 20测量一般疲劳、身体疲劳、精神疲劳、动力下降和活动减少。
与中度复杂CHD相比，复杂CHD患者中身体疲劳（严重至极严重）更为常见（25%对52%，P = 0.006）。复杂CHD与严重至极严重的身体疲劳相关（比值比3.1（95%CI 1.1 - 9.1））。复杂CHD患者自我报告的NYHA分级高于中度复杂CHD患者。所有疲劳维度均与自我报告的NYHA分级呈正相关。
40岁以上复杂CHD患者报告严重至极严重身体疲劳的可能性是中度复杂CHD患者的三倍，且自我报告的NYHA分级更高。这凸显了在临床实践中考虑CHD复杂性的重要性。
