Document Detail


Relationship between exertional symptoms and functional capacity in patients with heart failure.
MedLine Citation:
PMID:  10362197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The present study was undertaken to investigate the relationship over time between exertional symptoms in heart failure and functional capacity. BACKGROUND: Most clinicians rely on exertional symptoms rather than on exercise testing to assess functional capacity in heart failure. However, it remains uncertain whether the subjective symptoms reported by patients provide a reliable index of functional capacity. METHODS: Fifty patients with heart failure underwent serial cardiopulmonary exercise testing and evaluation of exertional fatigue and dyspnea over a period of one to four years. Exercise testing was performed using the Naughton treadmill protocol and a MedGraphics metabolic cart. Fatigue and dyspnea were each scored from 0 to 3 (p = none, 1 = mild, 2 = moderate, 3 = severe). A composite symptom score was determined by adding together the fatigue and dyspnea scores. RESULTS: Patients underwent a total of 185 tests at an average interval of 4.3 months (average tests/patient = 3.7). Composite symptom scores noted at the time of exercise testing correlated significantly with peak exercise minute oxygen consumption (VO2) (r = 0.47, p < 0.01). In addition, the change in symptoms scores and change in peak VO2 noted between the baseline and final exercise test correlated significantly (r = 0.50, p < 0.01). However, patients reported few or no symptoms (symptom score < or =2) 45% of the time when peak VO2 was <14 ml/min/kg, consistent with a severe functional disability, and 72% of the time when peak VO2 was 14 to 18 ml/min/kg, consistent with moderate functional disability. CONCLUSIONS: Exertional symptoms reported by patients with heart failure generally correlate with maximal exercise capacity. However, exertional symptoms frequently underestimate the severity of functional disability. Cardiopulmonary exercise testing rather than symptoms should be used to assess functional capacity in heart failure.
Authors:
J R Wilson; S Hanamanthu; D B Chomsky; S F Davis
Related Documents :
11802677 - Effects of biofeedback training on voluntary heart rate control during dynamic exercise.
15101027 - The reversibility of increased airways resistance in chronic heart failure measured by ...
17452607 - Development of a ventilatory classification system in patients with heart failure.
8774327 - Neuroendocrine response to standing and mild exercise in patients with untreated severe...
9644717 - Bioavailability of timolol and aceclidine after ocular instillation in the rabbit.
12043827 - Kinematic analysis of butterfly turns of international and national swimmers.
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  33     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-06-22     Completed Date:  1999-06-22     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1943-7     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Division, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2170, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Disease / metabolism,  physiopathology
Exercise Test
Exercise Tolerance / physiology*
Female
Heart Failure / metabolism,  physiopathology*
Humans
Male
Middle Aged
Oxygen Consumption
Physical Exertion / physiology*
Prognosis
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
R0-1 HL53059/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Natural variability of circulating levels of cytokines and cytokine receptors in patients with heart...
Next Document:  Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: ...