Resumen de Comparative Value of NYHA Functional Class and Quality‐of‐Life Questionnaire Scores in Assessing Heart Failure
Leonidas V. Athanasopoulos, Athanasios Dritsas, Helen A. Doll, Dennis V. Cokkinos
PURPOSE: To assess the relationships between New York Heart Association (NYHA) functional class, quality of life, aerobic capacity (peak oxygen uptake, V̇O2), ventilatory efficiency (minute ventilation/carbon dioxide production slope, VE/V̇CO2 slope), and brain natriuretic peptide (BNP) in creating a model for predicting peak V̇O2. 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 V̇O2 and VE/V̇CO2 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 V̇O2, explaining 63% of its variability (adjusted R2 = 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.
