ArticleArquivos brasileiros de cardiologia2023
Incremental Role of New York Heart Association Class and Cardiopulmonary Exercise Test Indices for Prognostication in Heart Failure: A Cohort Study.
Article in Arquivos brasileiros de cardiologia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 9 citations in OpenAlex.
- Association between fibrinogen and decline in cardiorespiratory fitness in patients undergoing cardiopulmonary exercise testing: a large cross-sectional study.Frontiers in cardiovascular medicine · 2026Article
- Efficacy of vericiguat in patients with chronic heart failure and reduced ejection fraction: a prospective observational study.BMC cardiovascular disorders · 2025Observational
- Short-term changes of right ventricular-pulmonary artery coupling after TAVR and their association with clinical outcomes.Frontiers in cardiovascular medicine · 2025Article
- Risk Assessment in Heart Failure: Comprehensive is Always Better!Arquivos brasileiros de cardiologia · 2023Article
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8 authors at 1 institution in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCentral Illustration : Incremental Role of New York Heart Association Class and Cardiopulmonary Exercise Test Indices for Prognostication in Heart Failure: A Cohort Study LVEF: left ventricular ejection fraction; HR: hazard ratio; CI: confidence interval; NYHA: New York Heart Association; VO 2: oxygen consumption.
backgroundThe accuracy of the New York Heart Association (NYHA) classification to assess prognosis may be limited compared with objective cardiopulmonary exercise test (CPET) parameters in heart failure (HF).
objectiveTo investigate the prognostic value of the NYHA classification in addition to Weber class.
methodsAdult outpatients with HF undergoing CPET in a Brazilian tertiary care center were included. The physician-assigned NYHA class and the CPET-derived Weber class were stratified into "favorable" (NYHA I or II; Weber A or B) or "adverse" (NYHA III or IV; Weber C or D). Patients with one favorable class and one adverse class were defined as "discordant." The primary endpoint was time to all-cause mortality. A 2-sided p value < 0.05 was considered statistically significant.
resultsA total of 834 patients were included. Median age was 57 years; 42% (351) were female, and median left ventricular ejection fraction was 32%. Among patients with concordant NYHA and Weber classes, those with adverse NYHA and Weber classes had significantly higher all-cause mortality compared to those with favorable classes (hazard ratio [HR]: 5.65; 95% confidence interval [CI]: 3.38 to 9.42). Among patients with discordant classes, there was no significant difference in all-cause mortality (HR: 1.38; 95% CI: 0.82 to 2.34). In the multivariable model, increments in NYHA class (HR: 1.55 per class increase; 95% CI: 1.26 to 1.92) and reductions in peak VO 2 (HR: 1.47 per 3 ml/kg/min decrease; 95% CI: 1.28 to 1.70) significantly predicted mortality.
conclusionsPhysician-assigned NYHA class and objective CPET measures provide complementary prognostic information for patients with HF.
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