Research article summary (published 29 Sep 2009):

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

Full 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.

Author information

Author/s: Russell, Stuart D (SD); Saval, Matthew A (MA); Robbins, Jennifer L (JL); Ellestad, Myrvin H (MH); Gottlieb, Stephen S (SS); Handberg, Eileen M (EM); Zhou, Yi (Y); Chandler, Bleakley (B); HF-ACTION Investigators;

Affiliation: Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA. srusse14(-atsign-)jhmi.edu

Grants: 5U01HL063747 (Agency:NHLBI NIH HHS) ; 5U01HL064250 (Agency:NHLBI NIH HHS) ; 5U01HL064257 (Agency:NHLBI NIH HHS) ; 5U01HL064264 (Agency:NHLBI NIH HHS) ; 5U01HL064265 (Agency:NHLBI NIH HHS) ; 5U01HL066482 (Agency:NHLBI NIH HHS) ; 5U01HL066491 (Agency:NHLBI NIH HHS) ; 5U01HL066494 (Agency:NHLBI NIH HHS) ; 5U01HL066497 (Agency:NHLBI NIH HHS) ; 5U01HL066501 (Agency:NHLBI NIH HHS) ; 5U01HL068973 (Agency:NHLBI NIH HHS) ; 5U01HL068980 (Agency:NHLBI NIH HHS) ; P60AG10484 (Agency:NIA NIH HHS) ; R37AG18915 (Agency:NIA NIH HHS)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural

Journal: American heart journal (Am Heart J), published in United States. (Language: eng)

Reference: 2009-Oct; vol 158 (issue 4 Suppl) : pp S24-30

Dates: Created 2009/09/28; Completed 2009/10/29;

PMID: 19782785, status: MEDLINE (last retrieval date: 10/29/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adrenergic beta-Antagonists - therapeutic use Aldosterone Antagonists - therapeutic use Cardiac Pacing, Artificial - methods Data Collection - statistics & numerical data Electrocardiography Exercise Test - classification; statistics & numerical data Exercise Tolerance Female Heart - physiopathology

Heart Failure - diagnosis; physiopathology; therapy Humans Male Middle Aged Oxygen Consumption - physiology Pulmonary Ventilation - physiology Severity of Illness Index Treatment Outcome Ventricular Dysfunction, Left - physiopathology; therapy

Associated Chemicals: Adrenergic beta-Antagonists (0) ; Aldosterone Antagonists (0)

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