[Functional classification of cardiac insufficiency].
Several systems have been proposed for assessing the degree of functional impairment of chronic cardiac failure in order to be able to compare patients and to appreciate progression of the condition in individual patients. The NYHA classification is subjective, not very reproducible, and does not provide a good prediction of exercise capacity. The Canadian classification is not much better. Feinstein's classification is too complex, impractical and has never been validated. The specific activity scale proposed by Goldman indicates the degree of functional incapacity by comparison with activities of everyday life selected for their variability and classified according to the effort required to perform them. This classification has a good reproducibility and correlates well with exercise stress testing (exercise duration, VO2 max). However, it is not particularly well suited to the French population. The examples are not very precise; in addition, contradictions are possible, making it difficult to classify some patients. The authors propose a specific activity scale adapted for French patients. This classification was studied in 45 patients with chronic primary dilated cardiomyopathy. It was reproducible and correlated well with peak VO2. The progressive design of the symptom questionnaire avoids contradiction. This classification could be useful both in everyday practice and for multicentre research studies.
Gibelin
P
P
Service de cardiologie, hôpital Pasteur, CHRU de Nice.
Dadoun-Dybal
M
M
Morand
P
P
D000203:Activities of Daily Living; D005080:Exercise Test; D006305:Health Status Indicators; D006333:Heart Failure / Q000145:classification* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D011795:Surveys and Questionnaires
Classification fonctionnelle de l'insuffisance cardiaque.