Physical and psychological attributes of fatigue in female heart transplant recipients

Catherine Joyce Reyes, Lorraine S. Evangelista, Lynn Doering, Kathleen Dracup, David A. Cesario, Jon Kobashigawa

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background The attributes of fatigue after orthotopic heart transplantation (OHT) are poorly understood. We conducted this study to assess the prevalence, severity and correlates of fatigue among female OHT survivors. Methods Fifty women (age 54.7 ± 13.0 years) from a single heart transplant center, who underwent OHT 5.1 ± 4.4 (mean ± SD) years earlier, completed a battery of questionnaires including the Profile of Mood States-fatigue sub-scale to assess levels of fatigue, the Beck Depression Inventory to measure depression, and the Short Form-36 to measure functional status and mental health. Demographic and clinical data were obtained from self-reports and medical chart reviews. Results Women reported mean scores of 15.7 ± 6.8 (range 3 to 27), 13.2 ± 8.2 (range 0 to 38), 37.2 ± 10.8 (range 22 to 62) and 41.5 ± 11.2 (range 17 to 60) for fatigue, depression, functional status and mental health, respectively. Univariate analyses revealed that sociodemographic and clinical variables (e.g., age, employment status, anemia, renal insufficiency) were significantly related to fatigue (p < 0.001). Likewise, depression, functional status and mental health were also significantly related to fatigue (p < 0.001). In a multivariate model, age (adjusted R2 = 0.23, p < 0.001), anemia (adjusted R2 = 0.39, p < 0.001), functional status (adjusted R2 = 0.60, p < 0.001) and depression (adjusted R2 = 0.69, p < 0.001) were significant predictors of fatigue. The model explained 69% of the variance in fatigue (p < 0.001). Conclusions Fatigue is common in women after OHT and is associated with both physiologic and psychologic factors. Clinicians should evaluate all female recipients for symptoms of fatigue, especially those with anemia, renal insufficiency, poor functional status and depression. Other potential mediators of fatigue, such as the denervated donor heart and type of immunosuppressive regimen, may also play a role and require further study.

Original languageEnglish (US)
Pages (from-to)614-619
Number of pages6
JournalJournal of Heart and Lung Transplantation
Issue number5
StatePublished - May 2004
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation


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