Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 16:21:100601.
doi: 10.1016/j.ijcchd.2025.100601. eCollection 2025 Sep.

Fatigue in adults with congenital heart disease aged over 40 years

Linda Ternrud  1   2 , Bengt Johansson  3   4 , David Sparv  2 , Zacharias Mandalenakis  5 , Christina Christersson  6 , Liesbet Van Bulck  7 , Philip Moons  7   8   9 , Camilla Sandberg  10 , Joanna Hlebowicz  1   2
Affiliations

Fatigue in adults with congenital heart disease aged over 40 years

Linda Ternrud et al. Int J Cardiol Congenit Heart Dis. .

Abstract

Background: 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).

Methods: 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.

Results: Physical fatigue (severe to very severe) was more common in complex CHD compared with moderately complex CHD (25 % vs. 52 %, p = 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.

Conclusions: 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.

Keywords: Congenital heart disease; Fatigue; MFI-20; Patient-reported outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: two of the authors (Zacharias Mandalenakis and Philip Moons) are IJC Congenital Heart Disease Editorial Board Members but had no involvement with the handling of this paper. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Fatigue scores dichotomized in none, mild, and moderate vs. severe and very severe in controls, moderately complex congenital heart disease (CHD) and complex CHD. A; General fatigue, B; Physical fatigue, C; mental fatigue, D; reduced motivation, E; reduced activity.
Fig. 2
Fig. 2
Self-reported New York Heart Association Functional Class; experienced limitations in physical activity. There was a difference between limitations in physical activity between patients with moderately complex congenital heart disease (CHD) and patients with complex CHD. There were two missing cases: the moderately complex CDH-group.
See this image and copyright information in PMC

References

    1. Liu Y., Chen S., Zuhlke L., Black G.C., Choy M.K., Li N., et al. Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies. Int J Epidemiol. 2019;48:455–463. doi: 10.1093/ije/dyz009. - DOI - PMC - PubMed
    1. Moons P., Bovijn L., Budts W., Belmans A., Gewillig M. Temporal trends in survival to adulthood among patients born with congenital heart disease from 1970 to 1992 in Belgium. Circulation. 2010;122:2264–2272. doi: 10.1161/CIRCULATIONAHA.110.946343. - DOI - PubMed
    1. Mandalenakis Z., Rosengren A., Skoglund K., Lappas G., Eriksson P., Dellborg M. Survivorship in children and young adults with congenital heart disease in Sweden. JAMA Intern Med. 2017;177:224–230. doi: 10.1001/jamainternmed.2016.7765. - DOI - PubMed
    1. van der Linde D., Konings E.E., Slager M.A., Witsenburg M., Helbing W.A., Takkenberg J.J., et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;58:2241–2247. doi: 10.1016/j.jacc.2011.08.025. - DOI - PubMed
    1. Marelli A.J., Ionescu-Ittu R., Mackie A.S., Guo L., Dendukuri N., Kaouache M. Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010. Circulation. 2014;130:749–756. doi: 10.1161/CIRCULATIONAHA.113.008396. - DOI - PubMed

LinkOut - more resources