Fibromyalgia has a high prevalence and impact in cardiac failure patients

Abstract

Objective: Chronic cardiac failure (CCF) shares several clinical features with fibromyalgia (FM), a syndrome of increased central sensitivity and musculoskeletal pain. FM frequently coexists with other chronic illness. Musculoskeletal pain is reported in patients with CCF; however, the prevalence and impact of FM in patients with CCF is not known. This research aims to assess the prevalence and effects of concurrent FM in patients with CCF and to identify other coexisting central sensitivity syndromes. Material and Methods: In a cross-sectional study, demographic, clinical, and functional information was gathered from participants with CCF from public and private clinics. Cardiac failure severity was rated using the New York Heart Association (NYHA) scale. FM diagnosis was determined using 2011 American College of Rheumatology (ACR) criteria. The short-form 36 (SF-36) assessed overall health function. Results: Of the 57 CCF participants (63.2% male, mean age 70.3 years), 22.8% (n=13) met FM diagnostic criteria. CCF patients with FM had poorer outcomes across multiple SF-36 domains (p<0.05), compared to those without, despite having comparable CCF severity. Those with FM were more likely to report other central sensitivity syndromes, especially temporomandibular joint dysfunction (mean Δ=23%, p<0.05), headache (mean Δ=28.8%, p<0.05), and irritable bladder (mean Δ=14%, p<0.05). Conclusion: High prevalence of FM was found in patients with CCF. This was associated with increased likelihood of other comorbid central sensitivity syndromes and with poorer clinical outcomes. The recognition of coexisting FM in patients with CCF provides an important opportunity to improve health outcomes by managing FM-related symptoms, in addition to symptoms that relate specifically to CCF.

Comorbid fibromyalgia: A qualitative review of prevalence and importance

“…Cardiac failure is not commonly associated with chronic pain. Therefore, the report that FM occurred in 23% of persons with cardiac failure is of particular interest (Gist et al., ). In this study of 57 patients, 63% male and mean age 70 years, Gist and coauthors assessed FM using the 2011 ACR criteria, and overall health function was assessed with the short‐form (SF‐36).…”

The Role of Depressive Disorders in Autonomic Cardiovascular Dysregulation in Fibromyalgia

“…Autonomic dysregulation in FM sufferers reflects reduced adaptability and poor adjustment of the organism. Moreover, there is evidence that FM is associated with an increased risk of cardiovascular diseases; peculiarities in autonomic control may be involved in their pathogenesis (82,83). The involvement of depressive disorders in autonomic dysregulation underlines the importance of diagnosing and treating comorbid affective disorders in the management of FM.…”

Prevalence of chronic pain and chronic widespread pain among subjects with heart failure in the general population: The HUNT study

“…However, one previous study reported that widespread pain was a risk factor for cardiovascular mortality (Tesarz et al, 2019). Another study investigated the several clinical features between HF and fibromyalgia and reported a prevalence of 22.8% of the studied cohort fulfilling both fibromyalgia diagnosis criteria and HF (Gist et al, 2017). This underscores the relationship between CWP and HF as relevant.…”

“…It is still not established if the pain is related to HF itself, high age, or the burden of comorbidity. Studies suggest that HF shares several clinical features with fibromyalgia, a syndrome characterized by chronic widespread pain (CWP), often attributed to increased central sensitivity (Gist et al, 2017). Central sensitization is a complex phenomenon with amplified signalling and enhanced sensitivity of nociceptive neurons within the central nervous system.…”