TY - JOUR
T1 - New York Heart Association functional class predicts exercise parameters in the current era
AU - Russell, Stuart D.
AU - Saval, Matthew A.
AU - Robbins, Jennifer L.
AU - Ellestad, Myrvin H.
AU - Gottlieb, Stephen S.
AU - Handberg, Eileen M.
AU - Zhou, Yi
AU - Chandler, Bleakley
N1 - Funding Information:
This research was supported by National Institutes of Health grants: 5U01HL063747, 5U01HL068973, 5U01HL066501, 5U01HL066482, 5U01HL064250, 5U01HL066494, 5U01HL064257, 5U01HL066497, 5U01HL068980, 5U01HL064265, 5U01HL066491, 5U01HL064264, R37AG18915, and P60AG10484.
PY - 2009/10
Y1 - 2009/10
N2 - 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 Vo2). In addition, relationships between these 2 measurements have not been examined in the current medical era when patients are using β-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 Vo2 was examined. In addition, the effects of β-blockers, aldosterone antagonists, and CRT therapy on these relationships were compared. Results: The NYHA II patients have a significantly higher peak Vo2 (16.1 ± 4.6 vs 13.0 ± 4.2 mL/kg per minute), a lower ventilation (Ve)/Vco2 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 β-blockers, aldosterone antagonists, or CRT therapy. Finally, with increasing age, a significant difference in peak Vo2, Ve/Vco2 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.
AB - 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 Vo2). In addition, relationships between these 2 measurements have not been examined in the current medical era when patients are using β-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 Vo2 was examined. In addition, the effects of β-blockers, aldosterone antagonists, and CRT therapy on these relationships were compared. Results: The NYHA II patients have a significantly higher peak Vo2 (16.1 ± 4.6 vs 13.0 ± 4.2 mL/kg per minute), a lower ventilation (Ve)/Vco2 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 β-blockers, aldosterone antagonists, or CRT therapy. Finally, with increasing age, a significant difference in peak Vo2, Ve/Vco2 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.
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U2 - 10.1016/j.ahj.2009.07.017
DO - 10.1016/j.ahj.2009.07.017
M3 - Article
C2 - 19782785
AN - SCOPUS:70349282152
SN - 0002-8703
VL - 158
SP - S24-S30
JO - American heart journal
JF - American heart journal
IS - 4 SUPPL.
ER -