Clinical InvestigationAssociation of Functional and Health Status Measures in Heart Failure
Section snippets
Patients
Forty-one male patients with stable HF (mean age 68 ± 12 years) participated in the study. HF was documented by clinical history and diagnosis in outpatient medical records, and an ejection fraction (EF) <40%. Ischemic HF (n = 22) was defined by having a history of myocardial infarction, coronary bypass surgery, or documented angiographic coronary disease. Only patients with stable, compensated HF >30 years of age were included in the study. Written informed consent was obtained from all
Exercise Test Responses
Exercise test results are listed in Table 3. The mean maximal perceived exertion was 17.6 ± 2.0, and the mean peak respiratory exchange ratio was 1.14 ± 0.23, suggesting that maximal effort was achieved by most patients. The mean maximal heart rate of 124 ± 28 beats/min was lower than that expected for age (82% of predicted), reflecting that many patients were limited by symptoms associated with HF, that heart rate was limited by the effects of β-blockade, or both. Mean maximal oxygen uptake
Discussion
The present results suggest that commonly-used functional measures, estimates of quality of life, and symptom tools in patients with HF generally have only modest associations with peak VO2 and with one another. The clinical implications of these findings are that: (1) each test or instrument targets a specific aspect of clinical status and they should not be considered interchangeable and (2) none of these measures alone is a reliable surrogate for peak VO2.
Peak VO2 was used as the dependent
Summary
Health status, including functional capabilities, symptoms associated with daily activities, and physical or psychologic well-being are important indices that are widely used in the assessment of interventions for HF. Accurate and reliable tools that quantify health status are important to appropriately assess responsiveness to therapy in this population. We observed that tools commonly used to assess health and functional status in HF had only modest associations with peak VO2 and with
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