# Fatigue in Heart Failure: A Secondary Data Analysis of the Atherosclerosis Risk in Communities Study

> **NIH NIH F31** · JOHNS HOPKINS UNIVERSITY · 2022 · $45,471

## Abstract

Project Summary
Heart failure (HF) affects an estimated 6.2 million adults in the United States.1 Importantly, this debilitating
syndrome causes significant morbidity and mortality with nearly 80,000 HF-related deaths reported annually.1
Fatigue is a prevalent and distressing symptom for patients with HF and evidence suggests that it has
significant prognostic and outcome implications.2,3,4 The presence and increased severity of fatigue in HF
increases the risk of hospitalization5,6 and mortality7,8 and is associated with increased depression3,4,9,10,
poorer quality of life11,12, worse self-care13, and reduced physical14,15,3, social14, and emotional functioning.16
Fatigue in HF has been characterized in the literature as two types 1) general fatigue and 2) exertional fatigue.
1) general fatigue and 2) exertional fatigue. General and exertional fatigue and their co-occurrence are
important to understand because their predictors and associated outcomes may differ. Accurate
identification of fatigue type may lead to different interventions to alleviate that fatigue. However, little
evidence examines patient reported and clinical outcome differences between general and exertional fatigue,
clinically relevant predictors of fatigue have not been identified, and differences in the fatigue experience
between HFrEF and HFpEF have not yet been explored. This creates a cap in our understanding of the risk
factors for, and associated outcomes of fatigue type in HF. Using a secondary data analysis, this study aims
to characterize fatigue types, quantify the relationship between fatigue type and clinical and patient
reported outcomes, and examine the cardiac structural and functional predictors of fatigue type in
those with HFrEF and HFpEF in the Atherosclerosis Risk in Communities (ARIC) study. This will be
accomplished through the following specific aims: AIM 1: Define distinct types of fatigue in individuals with
chronic heart failure. AIM 2: Quantify the longitudinal association between fatigue type and HF readmission
and mortality and quantify the cross-sectional association between fatigue type and quality of life. AIM 3:
Determine the cross-sectional relationship between measures of cardiac structure and function (left ventricular
(LV) structure, LV systolic function, LV diastolic function), HF phenotype (HFrEF vs HFpEF), and fatigue type
(adjusting for age, sex, socioeconomic status, BMI, comorbidities, and medications). This study will address
critical evidence gaps and provide an evidence base for future research to prevent and mitigate the effects of
fatigue in HF. It will lay the foundation for a future program of symptom science research investigating multi-
dimensional models of HF fatigue symptom science. This study aligns with the National Institute of Nursing
Research's strategic plan focus to advance knowledge in symptom science with the goal of developing and
testing innovative interventions to alleviate suffering from symptoms and improve ...

## Key facts

- **NIH application ID:** 10464036
- **Project number:** 1F31NR020136-01A1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Noelle Victoria Pavlovic
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $45,471
- **Award type:** 1
- **Project period:** 2022-09-01 → 2023-08-15

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10464036

## Citation

> US National Institutes of Health, RePORTER application 10464036, Fatigue in Heart Failure: A Secondary Data Analysis of the Atherosclerosis Risk in Communities Study (1F31NR020136-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10464036. Licensed CC0.

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