PMID- 8500245
OWN - NLM
STAT- MEDLINE
DCOM- 19930701
LR  - 20100324
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 87
IP  - 6 Suppl
DP  - 1993 Jun
TI  - Functional capacity in heart failure. Comparison of methods for assessment and 
      their relation to other indexes of heart failure. The V-HeFT VA Cooperative 
      Studies Group.
PG  - VI88-93
AB  - BACKGROUND: Left ventricular (LV) dysfunction plays a primary role in the 
      pathogenesis of congestive heart failure and correlates with prognosis, but a 
      strong quantitative relation between exercise performance and indexes of LV 
      function has not been demonstrated. We examined the relation between LV ejection 
      fraction at rest, oxygen consumption at peak exercise (VO2), patient and 
      physician assessments of clinical severity, and other clinical attributes in 804 
      patients with moderate heart failure. METHODS AND RESULTS: Ejection fraction 
      correlated weakly with VO2, and mean ejection fraction was related to severity of 
      symptoms. There was a statistical association between the patient's self-assessed 
      quality of life questionnaire score and the physician-assigned New York Heart 
      Association (NYHA) functional class; NYHA class was statistically associated with 
      exercise performance. To identify other factors that might influence exercise 
      capacity, comparisons of clinical attributes were made between patients grouped 
      by VO2 within each stratum of LV function. Exercise performance was inversely 
      related to plasma norepinephrine levels within the ejection fraction < 25% 
      stratum. The percentage of patients reaching their anaerobic threshold was not 
      different between groups, yet the peak heart rate increased with VO2 within all 
      strata. Elevated venous pressure and cardiomegaly were inversely related to 
      exercise performance. CONCLUSIONS: Clinical scales based on physician and patient 
      assessment of symptoms were statistically associated with exercise capacity but 
      do not accurately predict individual exercise performance. The strong association 
      of heart rate response to exercise performance suggests that the variability of 
      the chronotropic response to exercise contributes to differences in exercise 
      capacity among patients with a similar degree of LV dysfunction.
FAU - Smith, R F
AU  - Smith RF
AD  - VA Medical Center, Cardiology Section, Nashville, TN 37203.
FAU - Johnson, G
AU  - Johnson G
FAU - Ziesche, S
AU  - Ziesche S
FAU - Bhat, G
AU  - Bhat G
FAU - Blankenship, K
AU  - Blankenship K
FAU - Cohn, J N
AU  - Cohn JN
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - Drug Therapy, Combination
MH  - Exercise Test
MH  - Exercise Tolerance/physiology
MH  - Heart Failure/*diagnosis/drug therapy/epidemiology
MH  - *Heart Function Tests
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Quality of Life
MH  - Ventricular Function, Left/physiology
EDAT- 1993/06/01 00:00
MHDA- 1993/06/01 00:01
CRDT- 1993/06/01 00:00
PHST- 1993/06/01 00:00 [pubmed]
PHST- 1993/06/01 00:01 [medline]
PHST- 1993/06/01 00:00 [entrez]
PST - ppublish
SO  - Circulation. 1993 Jun;87(6 Suppl):VI88-93.