Background: Dyspnea and fatigue are distressing symptoms commonly seen in heart failure (HF) patients, and are closely related to patients' disease trajectory of contributes. Identifying the effect of symptom trends on disease outcomes is important to develop effective symptom management interventions in HF patients.
Methods: One hundred and twenty-two patients were recruited. Dyspnea, fatigue, clinical characteristics, and disease outcomes were measured at the baseline assessment, three months, and 12 months. Latent class growth model and Kaplan-Meier survival analysis were used on dyspnea and fatigueto examine the relationship ofdisease trajectories and effects on disease outcomes.
Results: A total of 122 patients were examined (mean age 62.8 土 13.0 yrs; 79% male; 39% NYHA lll/IV; 48% preserved systolic function HF). Three groups based on HF patients' dyspnea-fatigue trends were identified as “constantgood,” “recovery,” and “gettingworse.” The cumulative incidence ofafirst cardiac event in both dyspnea and fatigue groups yielded similar results. The quality of life score for the getting worse group was significantly higherthan that ofthe constantgood and recovery groups. The result ofthe log-ranktest was significant (%2 = 8.11, p = 0.017). Post hoc comparison showed that the prognosis status ofthe constant good group was better than that ofthe getting worse (p = 0.046) and recovery groups (p = 0.020), while getting worse and recovery groups did not differ in prognosis status (p = 0.30).
Conclusions: The results demonstrate the value oftracking symptoms over time to determine symptom trajectories as well as severe baseline (even with improvements at follow-ups) or increased fatigue over time were related to a worse event-free survival as compared with low but stable fatigue.