Objective: To examine the role of clinical and psychological characteristics as predictors of fatigue in CHF. Background: Little is known about predictors of fatigue in CHF. Next to heart failure characteristics, depressive symptoms and type-D personality may explain individual differences in fatigue. Methods: At baseline, 136 CHF outpatients (age ≤ 80 years) completed a questionnaire to assess depressive symptoms, type-D personality and cardiac symptoms. At one-year follow-up, they completed the Dutch Exertion Fatigue Scale and the Fatigue Assessment Scale to assess symptoms of fatigue. Medical information was obtained from the patients' medical records. Results: Exertion fatigue and general fatigue were identified as different manifestations of fatigue. We found that exertion fatigue at 12-month follow-up was predicted by decreased exercise capacity (β = −.35; p b .001), dyspnoea (β = 24; p = .002), hypertension (β = .16; p = .03), and depressive symptoms (β = .16; p = .05). In contrast, general fatigue at 12-month follow-up was predicted by dyspnoea (β = .24; p = .003), depressive symptoms (β = .27; p b .001), type-D personality (β = 17; p = .03), and sleep problems (β = .20; p = .01). Together, these variables explained 32% and 37% of the variance, respectively. Conclusion: The present study showed that fatigue was related to both clinical and psychological characteristics. The use of this knowledge may lead to a better understanding and treatment of the clinical manifestations of fatigue in CHF.

Type D was associated with impaired health status and increased depressive symptoms in CHF patients. These preliminary findings demonstrate the value of including personality factors in CHF research.

Symptoms of depression tend to persist during the first year post-MI. Cardiac history, prior depression and Type-D personality were identified as independent risk factors for persistence of depressive symptoms. The results of this study strongly argue for routine psychological screening during hospitalization for acute MI in order to identify patients who are at risk for chronicity of depressive symptoms and its deleterious effects on prognosis.

CHF patients with Type D personality are characterized by an increased oxidative stress burden, apparent in the decreased antioxidant levels and an increased oxidative stress ratio.