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Am Heart J. 2009 Oct;158(4 Suppl):S24-30. doi: 10.1016/j.ahj.2009.07.017.

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

Collaborators (304)

O'Connor CM, Lee KL, Ellis SJ, Rendall DS, Whellan DJ, Piña IL, Keteyian SJ, Cooper LS, Boineau R, Fine LJ, Fleg JL, Leifer ES, Erickson V, Howlett JG, Miller NH, Isaac D, McKelvie R, Zannad F, Boozer S, Connolly P, Doll A, Ellis SJ, Frazier C, Mark D, McClanahan-Crowder M, Meyer M, Mickley BS, Rendall DS, Rich M, Rostami H, Settles S, Spinella K, Staib J, Thompson O, Abraham W, Biniakiewicz D, Homan J, Bittner V, Fitz-Gerald M, Ewald G, Craddock H, Flanagan J, Fonarow G, Erickson V, Colucci W, Lim NZ, Tokareva E, Alharethi R, Hershberger R, Nauman D, Keteyian SJ, Saval M, Kitzman DW, Fray BL, Moore B, Piña IL, Vest M, Smith A, Snell G, Wolfel E, Cantu M, Adams K, Glotzer J, Johnson V, Schumacher K, Blackburn G, Geither C, Moore S, Chandler AB Jr, Vaughn SB, Easler PJ, Williams D, Colmer M, Gardin JM, Dimick K, Sklar SK, Teller S, Ghali JK, Hale-Stenson K, Gheorghiade M, Strzelczyk T, Johnson MR, Vander Ark C, Goldberg LR, Kao A, Dekerlegand J, Kraus WE, Johnson J, Duscha BD, Mehra MR, Ventura H, Harris B, Colvin-Adams M, Duderstadt K, Meyer K, Steger M, Cabuay B, Oren R, Scovel P, Kao A, Stevens T, Haffey K, Mandacina C, Stewart A, Swank AM, Manire J, Thompson PD, Cosio-Lima L, Lagasse M, Naz T, Wagoner L, Roll SK, Yanowitz FG, Walker J, Mueller A, McCullough P, Coleman C, Dorrell KA, Washington T, Handberg E, Hill JA, Bakos J, Boyette A, Smith P, Williams C, Badenhop D, Schroeder S, Walter K, Kokkinos P, Collins E, Korsak L, Eichhorn E, Leonard A, Worley T, Fletcher G, Peasley P, Oldano P, Kostis J, Cosgrove NM, Thadani U, Rogan L, Thresher M, Turner J, Barnard D, Herman D, Contasti A, Sagerian M, Ofili E, Onwuanyi A, Nkemdiche S, Eisen H, Fitzpatrick J, Wald J, Wong J, Ellestad M, Kern L, Amsterdam EA, Burns MJ, Fedson S, Garg RK, Bennett P, Bond L, Chen L, Schrack J, Pearce D, Bond L, Palevo G, Serfass M, Forman D, Lopez MM, Talabi-Oates Y, Williams A, Truitte D, Baumann C, Adams J, Lawrence A, McNamara D, Gruendler E, Schneider V, Hutchins S, Hartwick A, Campbell P, Esposito M, Buchter C, Letterer RA, Taylor R, Wells C, Johnson B, Kaping B, Leathes S, O'Bryan J, Langley L, Hastings ET, Clancy C, Agruss N, Lawless C, Fortman R, McConnell TR, Wantz D, Walsh MN, Margiotti R, Russell S, Heck E, Lachmann J, Lippman D, McLaughlin J, Landzberg J, Mathus S, Cullinane DW, Voyles W, Lenz D, Kaczkowski S, David JL, Gillespie E, Keane-Richmond P, Krueger SK, Heiss L, Gottlieb S, Greenberg N, Gordon N, Parks E, Willoughby M, Kronenberg MW, Glenn J, Madison C, Arnold M, Smith JK, Azevedo E, Drobot G, Estrella-Holder E, Howlett J, Cooley-Warnell D, Yarn S, Isaac D, Grant J, Lyzun K, LeBlanc MH, Vienneau R, McKelvie RS, Beare L, Hancock J, Moe G, Golob D, Melvin K, Cymet A, Renton J, Nigam A, LaLonge J, Djaballah K, Aebehard P, Iliou MC, Sabatier R, Belin A, Cohen-Solal A, Hittinger L, Pitt B, Ades PA, Basta LL, Froelicher V, Hamel ME, Massie BM, Moyé L, Powell LH, Kraus WE, Johnson J, Piner L, Bensimhon D, Russell S, Gardin JM, Bess RL, Cohen GI, Keteyian SJ, Ehrman JK, Brawner CA, Miller NH, Blumenthal JA, Barbour K, Spruill TM, Marcus B, Raczynski J, Adams K, Donahue M, Felker M, Schulman KA, Weinfurt KP, Flynn KE, Reed S, Burnette A, Davidson-Ray L, Friedman JY, Li Y, Lin L, O'Neal B, Zile M, Johnson RH, Bensimhon DR, Bittner V, Boineau R, Dunlap ME, Kraus WE, O'Connor CM, Moe G, Wertheimer J, Whellan DJ.

Author information

  • 1Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA. srusse14@jhmi.edu

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.

PMID:
19782785
[PubMed - indexed for MEDLINE]
PMCID:
PMC2762947
Free PMC Article

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