title: Relationship of fatigue and exercise capacity with emotional and physical state in patients with coronary artery disease admitted for rehabilitation program.
abstract: BACKGROUND
  The relationship between subjective fatigue, exercise capacity, and symptoms of depression and anxiety in patients with coronary artery disease (CAD) needs to be specified.
  
  
  METHODS
  In this cross-sectional study, a total of 1,470 (64% men; mean age 57 ± 11 years) consecutive CAD patients admitted for cardiac rehabilitation after treatment of acute cardiac events were evaluated for demographic characteristics, for past and current diagnosis and treatment, for New York Heart Association (NYHA) class, for symptoms of depression and for symptoms of anxiety using the Hospital Anxiety and Depression Scale, and for subjective fatigue using the Multidimensional Fatigue Inventory. On the next day, all patients underwent exercise capacity evaluation using a standard bicycle ergometer testing procedure.
  
  
  RESULTS
  In univariate regression analyses, there was the strongest positive association between scores on all Multidimensional Fatigue Inventory subscales and scores on the Hospital Anxiety and Depression Scale depression and anxiety subscales and between exercise capacity and NYHA class. Multivariate regression analyses revealed that symptoms of depression were the strongest positive determinants of all dimensions of subjective fatigue and, together with other significant variables, accounted for 17% to 29% of the variance. However, neither depressive nor anxious symptoms were significant determinants of exercise capacity. The association between subjective fatigue and exercise capacity and vice versa was minimal.
  
  
  CONCLUSIONS
  Subjective fatigue in CAD patients is strongly related to symptoms of depression and symptoms of anxiety. In contrast, exercise capacity in CAD patients is strongly related to NYHA functional class, with no relationship to symptoms of depression and anxiety.
authors.affiliation: Institute of Psychophysiology and Rehabilitation of the Lithuanian University of Health Sciences, Palanga, Lithuania. a.bunevicius@yahoo.com
authors.forename: Adomas
authors.initials: A
authors.lastname: Bunevicius
authors.forename: Albinas
authors.initials: A
authors.lastname: Stankus
authors.forename: Julija
authors.initials: J
authors.lastname: Brozaitiene
authors.forename: Susan S
authors.initials: SS
authors.lastname: Girdler
authors.forename: Robertas
authors.initials: R
authors.lastname: Bunevicius
mesh_terms: D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D004644:Emotions / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011379:Prognosis; D012189:Retrospective Studies