| Title | New York Heart Association functional class predicts exercise parameters in the current era. | | Author(s) | Russell SD, Saval MA, Robbins JL, Ellestad MH, Gottlieb SS, Handberg EM, Zhou Y, Chandler B, HF-ACTION Investigators | | Institution | Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA. srusse14@jhmi.edu | | Source | Am Heart J 2009 Oct; 158(4 Suppl):S24-30. | | MeSH | Adrenergic beta-Antagonists
Aldosterone Antagonists
Cardiac Pacing, Artificial
Data Collection
Electrocardiography
Exercise Test
Exercise Tolerance
Female
Heart
Heart Failure
Humans
Male
Middle Aged
Oxygen Consumption
Pulmonary Ventilation
Severity of Illness Index
Treatment Outcome
Ventricular Dysfunction, Left
| | Abstract | BACKGROUND: The New York Heart Association (NYHA) functional class is a subjective estimate of a patient's functional ability based on symptoms that do not always correlate with the objective estimate of functional capacity, peak oxygen consumption (peak V(O2)). In addition, relationships between these 2 measurements have not been examined in the current medical era when patients are using beta-blockers, aldosterone antagonists, and cardiac resynchronization therapy (CRT). Using baseline data from the HF-ACTION (Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing) study, we examined this relationship.
METHODS: One thousand seven hundred fifty-eight patients underwent a symptom-limited metabolic stress test and stopped exercise due to dyspnea or fatigue. The relationship between NYHA functional class and peak V(O2) was examined. In addition, the effects of beta-blockers, aldosterone antagonists, and CRT therapy on these relationships were compared.
RESULTS: The NYHA II patients have a significantly higher peak Vo(2) (16.1 +/- 4.6 vs 13.0 +/- 4.2 mL/kg per minute), a lower ventilation (Ve)/V(CO2) slope (32.8 +/- 7.7 vs 36.8 +/- 10.4), and a longer duration of exercise (11.0 +/- 3.9 vs 8.0 +/- 3.4 minutes) than NYHA III/IV patients. Within each functional class, there was no difference in any of the exercise parameters between patients on or off of beta-blockers, aldosterone antagonists, or CRT therapy. Finally, with increasing age, a significant difference in peak Vo(2), Ve/V(CO2) slope, and exercise time was found.
CONCLUSION: For patients being treated with current medical therapy, there still is a difference in true functional capacity between NYHA functional class II and III/IV patients. However, within each NYHA functional class, the presence or absence or contemporary heart failure therapies does not alter exercise parameters. | | Language | eng | | Pub Type(s) | Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
| | PubMed ID | 19782785 |
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