PMID- 35384966
OWN - NLM
STAT- Publisher
LR  - 20240220
IS  - 1678-4170 (Electronic)
IS  - 0066-782X (Print)
IS  - 0066-782X (Linking)
VI  - 118
IP  - 6
DP  - 2022 Apr 4
TI  - Low Concordance between NYHA Classification and Cardiopulmonary Exercise Test 
      Variables in Patients with Heart Failure and Reduced Ejection Fraction.
PG  - 1118-23
LID - S0066-782X2022005003201 [pii]
LID - 10.36660/abc.20210222 [doi]
AB  - BACKGROUND: The New York Heart Association (NYHA) functional classification is 
      the most commonly used classification system for heart failure (HF), whereas 
      cardiopulmonary exercise testing (CPET) is the gold standard for functional 
      status evaluation in HF. OBJECTIVE: This study aimed to analyze correlation and 
      concordance between NYHA classes and CPET variables. METHODS: HF patients with 
      clinical indication for CPET and ejection fraction (EF) < 50% were selected. 
      Correlation (Spearman coefficient) and concordance (kappa) between NYHA 
      classification and CPET-based classifications were analyzed. A p < 0.05 was 
      accepted as significant. RESULTS: In total, 244 patients were included. Mean age 
      was 56 +/- 14 years, and mean EF was 35.5% +/- 10%. Distribution of patients 
      according to NYHA classification was 31.2%% class I, 48.3% class II, 19.2% class 
      III, and 1.3% class IV. Correlation (r) between NYHA and Weber classes was 0.489 
      (p < 0.001), and concordance was 0.231 (p < 0.001). Correlation (r) between NYHA 
      and ventilatory classes (minute ventilation/carbon dioxide production [VE/VCO2] 
      slope) was 0.218 (p < 0.001), and concordance was 0.002 (p = 0.959). Spearman 
      correlation between NYHA and CPET score classes was 0.223 (p = 0.004), and kappa 
      concordance was 0.027 (p = 0.606). CONCLUSION: There was a moderate association 
      between NYHA and Weber classes, although concordance was low. Ventilatory 
      (VE/VCO2slope) and CPET score classes had a weak association and a low 
      concordance with NYHA classes.
FAU - Ritt, Luiz Eduardo Fonteles
AU  - Ritt LEF
AUID- ORCID: 0000-0001-9320-7999
AD  - Instituto D'or de Pesquisa e Ensino (IDOR), Hospital Cardio Pulmonar, Salvador, 
      BA - Brasil.
AD  - Escola Bahiana de Medicina e Saude Publica, Salvador, BA - Brasil.
FAU - Ribeiro, Rebeca Sadigursky
AU  - Ribeiro RS
AD  - Escola Bahiana de Medicina e Saude Publica, Salvador, BA - Brasil.
FAU - Souza, Isabela Pilar Moraes Alves de
AU  - Souza IPMA
AUID- ORCID: 0000-0003-0759-2531
AD  - Instituto D'or de Pesquisa e Ensino (IDOR), Hospital Cardio Pulmonar, Salvador, 
      BA - Brasil.
AD  - Escola Bahiana de Medicina e Saude Publica, Salvador, BA - Brasil.
FAU - Ramos, Joao Victor Santos Pereira
AU  - Ramos JVSP
AUID- ORCID: 0000-0002-7990-7937
AD  - Escola Bahiana de Medicina e Saude Publica, Salvador, BA - Brasil.
FAU - Ribeiro, Daniel Sadigursky
AU  - Ribeiro DS
AD  - Escola Bahiana de Medicina e Saude Publica, Salvador, BA - Brasil.
FAU - Feitosa, Gustavo Freitas
AU  - Feitosa GF
AD  - Instituto D'or de Pesquisa e Ensino (IDOR), Hospital Cardio Pulmonar, Salvador, 
      BA - Brasil.
FAU - Oliveira, Queila Borges de
AU  - Oliveira QB
AD  - Instituto D'or de Pesquisa e Ensino (IDOR), Hospital Cardio Pulmonar, Salvador, 
      BA - Brasil.
FAU - Stein, Ricardo
AU  - Stein R
AUID- ORCID: 0000-0003-2357-5176
AD  - Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 
      Porto Alegre, RS - Brasil.
FAU - Darze, Eduardo Sahade
AU  - Darze ES
AD  - Instituto D'or de Pesquisa e Ensino (IDOR), Hospital Cardio Pulmonar, Salvador, 
      BA - Brasil.
AD  - Escola Bahiana de Medicina e Saude Publica, Salvador, BA - Brasil.
LA  - por
LA  - eng
PT  - Journal Article
TT  - Baixa Concordancia entre a Classificacao da NYHA e as Variaveis do Teste de 
      Exercicio Cardiopulmonar em Pacientes com Insuficiencia Cardiaca e Fracao de 
      Ejecao Reduzida.
DEP - 20220404
PL  - Brazil
TA  - Arq Bras Cardiol
JT  - Arquivos brasileiros de cardiologia
JID - 0421031
SB  - IM
CIN - Arq Bras Cardiol. 2022 Jun 10;118(6):1124-1125. PMID: 35703650
PMC - PMC9345141
OAB - BACKGROUND: The New York Heart Association (NYHA) functional classification is 
      the most commonly used classification system for heart failure (HF), whereas 
      cardiopulmonary exercise testing (CPET) is the gold standard for functional 
      status evaluation in HF. OBJECTIVE: This study aimed to analyze correlation and 
      concordance between NYHA classes and CPET variables. METHODS: HF patients with 
      clinical indication for CPET and ejection fraction (EF) < 50% were selected. 
      Correlation (Spearman coefficient) and concordance (kappa) between NYHA 
      classification and CPET-based classifications were analyzed. A p < 0.05 was 
      accepted as significant. RESULTS: In total, 244 patients were included. Mean age 
      was 56 +/- 14 years, and mean EF was 35.5% +/- 10%. Distribution of patients 
      according to NYHA classification was 31.2%% class I, 48.3% class II, 19.2% class 
      III, and 1.3% class IV. Correlation (r) between NYHA and Weber classes was 0.489 
      (p < 0.001), and concordance was 0.231 (p < 0.001). Correlation (r) between NYHA 
      and ventilatory classes (minute ventilation/carbon dioxide production [VE/VCO(2)] 
      slope) was 0.218 (p < 0.001), and concordance was 0.002 (p = 0.959). Spearman 
      correlation between NYHA and CPET score classes was 0.223 (p = 0.004), and kappa 
      concordance was 0.027 (p = 0.606). CONCLUSION: There was a moderate association 
      between NYHA and Weber classes, although concordance was low. Ventilatory 
      (VE/VCO(2)slope) and CPET score classes had a weak association and a low 
      concordance with NYHA classes.
OABL- eng
COIS- Potencial conflito de interesse Nao ha conflito com o presente artigo
EDAT- 2022/04/07 06:00
MHDA- 2022/04/07 06:00
PMCR- 2022/03/21
CRDT- 2022/04/06 12:16
PHST- 2021/03/12 00:00 [received]
PHST- 2021/09/01 00:00 [accepted]
PHST- 2022/04/06 12:16 [entrez]
PHST- 2022/04/07 06:00 [pubmed]
PHST- 2022/04/07 06:00 [medline]
PHST- 2022/03/21 00:00 [pmc-release]
AID - S0066-782X2022005003201 [pii]
AID - abc.20210222 [pii]
AID - 10.36660/abc.20210222 [doi]
PST - aheadofprint
SO  - Arq Bras Cardiol. 2022 Apr 4;118(6):1118-23. doi: 10.36660/abc.20210222.