PMID- 18514929
OWN - NLM
STAT- MEDLINE
DCOM- 20080922
LR  - 20161124
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 14
IP  - 5
DP  - 2008 Jun
TI  - A comparison of patient and physician-rated New York Heart Association class in a 
      community-based heart failure clinic.
PG  - 379-87
LID - 10.1016/j.cardfail.2008.01.014 [doi]
AB  - OBJECTIVE: The New York Heart Association (NYHA) classification is recommended 
      for grading symptoms of chronic heart failure and is a powerful prognostic 
      marker. Patient-rated NYHA (Pa-NYHA) and physician-rated NYHA (Dr-NYHA) class 
      have never been compared directly, and it is unknown whether they carry similar 
      prognostic significance. METHODS AND RESULTS: NYHA class was rated independently 
      by a physician and patient in 1752 patients referred with suspected heart 
      failure. Pa-NYHA and Dr-NYHA varied by 1 class in 37.1% cases and by 2 classes in 
      12.8% cases. Mean Dr-NYHA and Pa-NYHA were higher in women than men (1.98 vs 
      1.89, P = .016; 2.17 vs 2.02, P = .002) despite less cardiac disease. Dr-NYHA 
      correlated more with 6-minute walk test distance and severity of left ventricular 
      systolic dysfunction than Pa-NYHA (Spearman's rho: -0.53 vs -0.44 and 0.32 vs 
      0.16). Dr-NYHA better predicted mortality when compared with Pa-NYHA (log-rank: 
      chi(2) = 105 vs 46, both P < .001). CONCLUSION: Patients rate NYHA differently 
      from physicians, and women rate NYHA differently from men. Dr-NYHA relates more 
      strongly to survival and severity of left ventricular systolic dysfunction, 
      suggesting that for physicians the NYHA classification may have become a "heart 
      failure severity score" and not as was intended, purely a measure of a patient's 
      symptoms and functional status.
FAU - Goode, Kevin M
AU  - Goode KM
AD  - Department of Cardiology, Castle Hill Hospital, Kingston-upon-Hull, United 
      Kingdom.
FAU - Nabb, Samantha
AU  - Nabb S
FAU - Cleland, John G F
AU  - Cleland JG
FAU - Clark, Andrew L
AU  - Clark AL
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080527
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
MH  - Aged
MH  - *Ambulatory Care Facilities/statistics & numerical data
MH  - *Community Health Services/statistics & numerical data
MH  - Exercise Test
MH  - Female
MH  - Heart Failure/drug therapy/mortality/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - United Kingdom
MH  - Walking
EDAT- 2008/06/03 09:00
MHDA- 2008/09/23 09:00
CRDT- 2008/06/03 09:00
PHST- 2007/09/12 00:00 [received]
PHST- 2008/01/21 00:00 [revised]
PHST- 2008/01/23 00:00 [accepted]
PHST- 2008/06/03 09:00 [pubmed]
PHST- 2008/09/23 09:00 [medline]
PHST- 2008/06/03 09:00 [entrez]
AID - S1071-9164(08)00042-0 [pii]
AID - 10.1016/j.cardfail.2008.01.014 [doi]
PST - ppublish
SO  - J Card Fail. 2008 Jun;14(5):379-87. doi: 10.1016/j.cardfail.2008.01.014. Epub 
      2008 May 27.