Correlation of the New York Heart Association classification and the cardiopulmonary exercise test: A systematic review

• Published in: International journal of cardiology 2018-07, Vol.263, p.88-93
• Main Authors: Lim, Fang Yi, Yap, Jonathan, Gao, Fei, Teo, Ling Li, Lam, Carolyn S.P., Yeo, Khung Keong
• Format: Article
• Language: English
• Subjects: Cardiopulmonary Exercise Test; Case-Control Studies; Exercise Test - classification; Exercise Test - standards; Functional classification; Heart failure; Heart Failure - classification; Heart Failure - diagnosis; Heart Failure - physiopathology; Humans; New York; New York Heart Association; Oxygen Consumption - physiology; Peak oxygen consumption; Societies, Medical - standards
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2018.04.021

The New York Heart Association (NYHA) classification is frequently used in the management of heart failure but may be limited by patient and physician subjectivity. Cardiopulmonary exercise testing (CPET) provides a potentially more objective measurement of functional status. We aim to study the correlation between NYHA classification and peak oxygen consumption (pVO2) on Cardiopulmonary Exercise Testing (CPET) within and across published studies. A systematic literature review on all studies reporting both NYHA class and CPET data was performed, and pVO2 from CPET was correlated to reported NYHA class within and across eligible studies. 38 studies involving 2645 patients were eligible. Heterogenity was assessed by the Q statistic, which is a χ2 test and marker of systematic differences between studies. Within each NYHA class, significant heterogeneity in pVO2 was seen across studies: NYHA I (n = 17, Q = 486.7, p