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Association between physician-perceived functional class and functional capacity measured by exercise stress test in patients with heart failure and reduced ejection fraction
Session:
Sessão de Posters 39 - Insuficiência cardíaca: abordagem a longo prazo
Speaker:
Carla Oliveira Ferreira
Congress:
CPC 2024
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Carla Oliveira Ferreira; Eduarda Silva; Fernando Mané; Rodrigo Silva; Inês Macedo Conde; Ana Sofia Fernandes; Mónica Dias; Filipe Silva Vilela; Carlos Galvão Braga; Cátia Costa Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u><span style="color:black">Introduction</span></u><span style="color:black">: The New York Heart Association (NYHA) functional classification is widely used in clinical practice, not only for the clinical and prognostic evaluation of heart failure (HF) patients but also for determining candidates for specific treatments. However, it is a subjective classification, in contrast to the exercise stress test, which is an accessible complementary examination that allows for the objective assessment of functional capacity.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u><span style="color:black">Aim</span></u><span style="color:black">: To evaluate the correlation and agreement between the NYHA functional classification as perceived by the physician and the exercise capacity assessed in the exercise test in patients with HFrEF and HFmrEF.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u><span style="color:black">Methods</span></u><span style="color:black">: An observational, analytical and retrospective study was conducted in the Cardiology Department. It included 300 patients with HF and left ventricular ejection fraction (LVEF) < 50%, who underwent an exercise stress test between January 2018 and December 2022.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u><span style="color:black">Results</span></u><span style="color:black">: Most patients were in NYHA functional class I (59.3%), with 36.7% in NYHA class II, and 4% in NYHA class III. The median LVEF was 39%, significantly lower in NYHA classes II and III (p < 0.001). The median of N-terminal pro B-type natriuretic peptide (NT-proBNP) was 780.50 pg/mL, with no significant differences among patients in NYHA classes I, II, or III (p = 0.192). The correlation between NYHA classes and functional capacity was 0.280 (p < 0.001), with an agreement of 0.150 (p = 0.000). The correlation between NYHA classes and heart rate recovery was 0.095 (p = 0.260).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u><span style="color:black">Conclusions</span></u><span style="color:black">: A moderate correlation was found between the NYHA class perceived by the physician and the objectively measured functional capacity during the exercise stress test, despite a reduced agreement. On the other hand, the correlation between the NYHA class and heart rate recovery was considered insignificant.</span></span></span></p>
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