PMID- 19782785 OWN - NLM STAT- MEDLINE DCOM- 20091029 LR - 20211020 IS - 1097-6744 (Electronic) IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 158 IP - 4 Suppl DP - 2009 Oct TI - New York Heart Association functional class predicts exercise parameters in the current era. PG - S24-30 LID - 10.1016/j.ahj.2009.07.017 [doi] 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 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. FAU - Russell, Stuart D AU - Russell SD AD - Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA. srusse14@jhmi.edu FAU - Saval, Matthew A AU - Saval MA FAU - Robbins, Jennifer L AU - Robbins JL FAU - Ellestad, Myrvin H AU - Ellestad MH FAU - Gottlieb, Stephen S AU - Gottlieb SS FAU - Handberg, Eileen M AU - Handberg EM FAU - Zhou, Yi AU - Zhou Y FAU - Chandler, Bleakley AU - Chandler B CN - HF-ACTION Investigators LA - eng SI - ClinicalTrials.gov/NCT00047437 GR - U01 HL064257/HL/NHLBI NIH HHS/United States GR - 5U01HL064264/HL/NHLBI NIH HHS/United States GR - P60AG10484/AG/NIA NIH HHS/United States GR - R01 AG018915/AG/NIA NIH HHS/United States GR - U01 HL063747-04/HL/NHLBI NIH HHS/United States GR - U01 HL064265/HL/NHLBI NIH HHS/United States GR - U01 HL066497/HL/NHLBI NIH HHS/United States GR - U01 HL064264/HL/NHLBI NIH HHS/United States GR - 5U01HL066482/HL/NHLBI NIH HHS/United States GR - U01 HL068980/HL/NHLBI NIH HHS/United States GR - 5U01HL064250/HL/NHLBI NIH HHS/United States GR - 5U01HL064265/HL/NHLBI NIH HHS/United States GR - U01 HL066491/HL/NHLBI NIH HHS/United States GR - 5U01HL068973/HL/NHLBI NIH HHS/United States GR - 5U01HL064257/HL/NHLBI NIH HHS/United States GR - U01 HL066482/HL/NHLBI NIH HHS/United States GR - 5U01HL063747/HL/NHLBI NIH HHS/United States GR - 5U01HL066491/HL/NHLBI NIH HHS/United States GR - U01 HL064250/HL/NHLBI NIH HHS/United States GR - U01 HL063747-02/HL/NHLBI NIH HHS/United States GR - R37AG18915/AG/NIA NIH HHS/United States GR - R37 AG018915/AG/NIA NIH HHS/United States GR - U01 HL063747-06S1/HL/NHLBI NIH HHS/United States GR - U01 HL066494/HL/NHLBI NIH HHS/United States GR - U01 HL063747-06/HL/NHLBI NIH HHS/United States GR - 5U01HL066501/HL/NHLBI NIH HHS/United States GR - U01 HL068973/HL/NHLBI NIH HHS/United States GR - 5U01HL068980/HL/NHLBI NIH HHS/United States GR - U01 HL063747-05/HL/NHLBI NIH HHS/United States GR - U01 HL063747/HL/NHLBI NIH HHS/United States GR - 5U01HL066494/HL/NHLBI NIH HHS/United States GR - U01 HL066501/HL/NHLBI NIH HHS/United States GR - U01 HL063747-01A2/HL/NHLBI NIH HHS/United States GR - 5U01HL066497/HL/NHLBI NIH HHS/United States GR - U01 HL063747-03/HL/NHLBI NIH HHS/United States GR - P30 AG021332/AG/NIA NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Adrenergic beta-Antagonists) RN - 0 (Mineralocorticoid Receptor Antagonists) SB - IM MH - Adrenergic beta-Antagonists/therapeutic use MH - Cardiac Pacing, Artificial/methods MH - Data Collection/statistics & numerical data MH - Electrocardiography MH - Exercise Test/classification/*statistics & numerical data MH - Exercise Tolerance MH - Female MH - Heart/physiopathology MH - Heart Failure/diagnosis/*physiopathology/therapy MH - Humans MH - Male MH - Middle Aged MH - Mineralocorticoid Receptor Antagonists/therapeutic use MH - Oxygen Consumption/*physiology MH - Pulmonary Ventilation/physiology MH - Severity of Illness Index MH - Treatment Outcome MH - Ventricular Dysfunction, Left/physiopathology/therapy PMC - PMC2762947 MID - NIHMS134636 FIR - O'Connor, Christopher M IR - O'Connor CM FIR - Lee, Kerry L IR - Lee KL FIR - Ellis, Stephen J IR - Ellis SJ FIR - Rendall, David S IR - Rendall DS FIR - Whellan, David J IR - Whellan DJ FIR - Pina, Ileana L IR - Pina IL FIR - Keteyian, Steven J IR - Keteyian SJ FIR - Cooper, Lawton S IR - Cooper LS FIR - Boineau, Robin IR - Boineau R FIR - Fine, Lawrence J IR - Fine LJ FIR - Fleg, Jerome L IR - Fleg JL FIR - Leifer, Eric S IR - Leifer ES FIR - Erickson, Virginia IR - Erickson V FIR - Howlett, Jonathan G IR - Howlett JG FIR - Miller, Nancy Houston IR - Miller NH FIR - Isaac, Debra IR - Isaac D FIR - McKelvie, Robert IR - McKelvie R FIR - Zannad, Faiez IR - Zannad F FIR - Boozer, Sharon IR - Boozer S FIR - Connolly, Patty IR - Connolly P FIR - Doll, Anthony IR - Doll A FIR - Ellis, Stephen J IR - Ellis SJ FIR - Frazier, Camille IR - Frazier C FIR - 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Bensimhon, Daniel R IR - Bensimhon DR FIR - Bittner, Vera IR - Bittner V FIR - Boineau, Robin IR - Boineau R FIR - Dunlap, Mark E IR - Dunlap ME FIR - Kraus, William E IR - Kraus WE FIR - O'Connor, Christopher M IR - O'Connor CM FIR - Moe, Gordon IR - Moe G FIR - Wertheimer, John IR - Wertheimer J FIR - Whellan, David J IR - Whellan DJ EDAT- 2009/10/15 06:00 MHDA- 2009/10/30 06:00 PMCR- 2010/10/01 CRDT- 2009/09/29 06:00 PHST- 2009/09/29 06:00 [entrez] PHST- 2009/10/15 06:00 [pubmed] PHST- 2009/10/30 06:00 [medline] PHST- 2010/10/01 00:00 [pmc-release] AID - S0002-8703(09)00554-7 [pii] AID - 10.1016/j.ahj.2009.07.017 [doi] PST - ppublish SO - Am Heart J. 2009 Oct;158(4 Suppl):S24-30. doi: 10.1016/j.ahj.2009.07.017.