New York Heart Association functional class predicts exercise parameters in the current era

Stuart D. Russell, Matthew A. Saval, Jennifer L. Robbins, Myrvin H. Ellestad, Stephen S. Gottlieb, Eileen M. Handberg, Yi Zhou, Bleakley Chandler

Research output: Contribution to journalArticle

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 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.

Original languageEnglish (US)
JournalAmerican Heart Journal
Volume158
Issue number4 SUPPL.
DOIs
StatePublished - Oct 2009

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Exercise
Mineralocorticoid Receptor Antagonists
Cardiac Resynchronization Therapy
Ventilation
Heart Failure
Physiological Stress
Therapeutics
Exercise Test
Oxygen Consumption
Dyspnea
Fatigue

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Russell, S. D., Saval, M. A., Robbins, J. L., Ellestad, M. H., Gottlieb, S. S., Handberg, E. M., ... Chandler, B. (2009). New York Heart Association functional class predicts exercise parameters in the current era. American Heart Journal, 158(4 SUPPL.). https://doi.org/10.1016/j.ahj.2009.07.017

New York Heart Association functional class predicts exercise parameters in the current era. / Russell, Stuart D.; Saval, Matthew A.; Robbins, Jennifer L.; Ellestad, Myrvin H.; Gottlieb, Stephen S.; Handberg, Eileen M.; Zhou, Yi; Chandler, Bleakley.

In: American Heart Journal, Vol. 158, No. 4 SUPPL., 10.2009.

Research output: Contribution to journalArticle

Russell, SD, Saval, MA, Robbins, JL, Ellestad, MH, Gottlieb, SS, Handberg, EM, Zhou, Y & Chandler, B 2009, 'New York Heart Association functional class predicts exercise parameters in the current era', American Heart Journal, vol. 158, no. 4 SUPPL.. https://doi.org/10.1016/j.ahj.2009.07.017
Russell SD, Saval MA, Robbins JL, Ellestad MH, Gottlieb SS, Handberg EM et al. New York Heart Association functional class predicts exercise parameters in the current era. American Heart Journal. 2009 Oct;158(4 SUPPL.). https://doi.org/10.1016/j.ahj.2009.07.017
Russell, Stuart D. ; Saval, Matthew A. ; Robbins, Jennifer L. ; Ellestad, Myrvin H. ; Gottlieb, Stephen S. ; Handberg, Eileen M. ; Zhou, Yi ; Chandler, Bleakley. / New York Heart Association functional class predicts exercise parameters in the current era. In: American Heart Journal. 2009 ; Vol. 158, No. 4 SUPPL.
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