Comparative value of NYHA functional class and quality-of-life questionnaire scores in assessing heart failure.
OBJECTIVE
To assess the relationships between New York Heart Association (NYHA) functional class, quality of life, aerobic capacity (peak oxygen uptake, (.)VO2), ventilatory efficiency (minute ventilation/carbon dioxide production slope, VE/(.)VCO2 slope), and brain natriuretic peptide (BNP) in creating a model for predicting peak (.)VO2).


METHODS
Cardiopulmonary exercise testing was performed in 62 patients. A baseline blood sample was taken to measure the N-terminal prohormone BNP (NT-proBNP). Patients also completed the Minnesota Living with Heart Failure Questionnaire (MLHF) and the Specific Activity Questionnaire (SAQ), and NYHA functional class was determined.


RESULTS
NYHA functional class correlated more strongly with SAQ score than with MLHF score. Peak (.)VO2 and VE/(.)VCO2 slope had stronger associations with NYHA functional class and SAQ score than with MLHF score. NT-proBNP plasma levels correlated more significantly with NYHA functional class and SAQ score (both P < .001) than with MLHF score. Using multiple linear regression analysis adjusted for age and sex, SAQ score, NT-proBNP, and etiology of heart failure had significant independent relationships with peak (.)VO2, explaining 63% of its variability (adjusted R(2) = 0.596).


CONCLUSIONS
Cardiopulmonary exercise variables and plasma NT-proBNP are associated more with NYHA functional class and SAQ score than with MLHF score. When combined, SAQ score, NT-proBNP, and etiology of heart failure can satisfactorily predict peak oxygen uptake.
Athanasopoulos
Leonidas V
LV
1st Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece.
Dritsas
Athanasios
A
Doll
Helen A
HA
Cokkinos
Dennis V
DV
D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy; D015444:Exercise; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010101:Oxygen Consumption; D010446:Peptide Fragments / Q000097:blood; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain