PMID- 32418718
OWN - NLM
STAT- MEDLINE
DCOM- 20200901
LR  - 20200901
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 127
DP  - 2020 Jul 15
TI  - Measurement of Functional Capacity to Discriminate Clinical from Subclinical 
      Heart Failure in Patients >/=65 Years of Age.
PG  - 84-91
LID - S0002-9149(20)30340-4 [pii]
LID - 10.1016/j.amjcard.2020.03.051 [doi]
AB  - In order to show that reduced functional capacity in subclinical heart failure 
      portends a higher risk of clinically overt (stage C) heart failure, we obtained 
      the Duke activity status index (DASI) and 6-minute walk distance (6MWD) in 814 
      patients (age 70 [interquartile range 67 to 74] years, 51% female) with 
      nonischemic subclinical heart failure. Reduced functional capacity was defined 
      as: (1) DASI-derived metabolic equivalents <7, (2) 6MWD <2 standard deviations 
      below the age-based normative mean (excluding those with mobility impairment) and 
      (3) reduced 6MWD with reclassification where DASI was discordant. Based on 
      reduced functional capacity and left ventricular dysfunction (LVD), subjects were 
      classified into; (1) Stage A heart failure (436 with neither LVD nor reduced 
      functional capacity), (2) Stage A with reduced functional capacity (n = 80), (3) 
      Stage B heart failure (182 with LVD but preserved functional capacity) and (4) 
      early stage C heart failure (52 with LVD and reduced functional capacity). 
      Outcome was assessed by Kaplan-Meier survival estimates and Cox proportional 
      hazard ratios. After a median follow-up of 13 months [interquartile range 11 to 
      19]), 76 (9%) developed heart failure - 6% of Stage A, 10% of Stage A-reduced 
      functional capacity, 9% of Stage B and 37% of early Stage C (p < 0.001). After 
      adjustment (for heart failure risk score, atrial fibrillation, pulmonary disease 
      and therapy), the hazard ratio for development of overt heart failure in early 
      Stage C was 5.92 (95% confidence intervals 2.92 to 11.54, p < 0.001) compared 
      with Stage A and 3.08 (95% confidence intervals 1.47 to 6.47, p = 0.003) compared 
      with Stage B.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Potter, Elizabeth
AU  - Potter E
AD  - Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; School of 
      Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 
      Australia.
FAU - Yang, Hong
AU  - Yang H
AD  - Menzies Institute for Medical Research, Hobart, Tasmania, Australia.
FAU - Wright, Leah
AU  - Wright L
AD  - Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
FAU - Wang, Bing
AU  - Wang B
AD  - Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; School of 
      Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 
      Australia.
FAU - Marwick, Thomas H
AU  - Marwick TH
AD  - Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; School of 
      Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 
      Australia. Electronic address: tom.marwick@baker.edu.au.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200411
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Exercise Test
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Heart Failure/*diagnosis/physiopathology
MH  - Humans
MH  - Male
MH  - Prognosis
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke Volume/*physiology
MH  - Ventricular Function, Left/*physiology
EDAT- 2020/05/19 06:00
MHDA- 2020/09/02 06:00
CRDT- 2020/05/19 06:00
PHST- 2020/03/11 00:00 [received]
PHST- 2020/03/30 00:00 [revised]
PHST- 2020/03/30 00:00 [accepted]
PHST- 2020/05/19 06:00 [pubmed]
PHST- 2020/09/02 06:00 [medline]
PHST- 2020/05/19 06:00 [entrez]
AID - S0002-9149(20)30340-4 [pii]
AID - 10.1016/j.amjcard.2020.03.051 [doi]
PST - ppublish
SO  - Am J Cardiol. 2020 Jul 15;127:84-91. doi: 10.1016/j.amjcard.2020.03.051. Epub 
      2020 Apr 11.