© 2002 by Heart
EDUCATION IN HEART
Heart failure
EXERCISE TESTING IN THE ASSESSMENT OF CHRONIC CONGESTIVE HEART FAILURE
Department of Medicine, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand
Correspondence to:
Correspondence to:
Dr John G Lainchbury, Department of Medicine, Christchurch School of Medicine and Health Sciences, University of Otago, Private Bag 4345, Christchurch, New Zealand;
john.lainchbury@chmeds.ac.nz
Keywords: exercise testing; congestive heart failure; peak oxygen uptake; natriuretic peptides
| The first 150 words of the full text of this article appear below. |
Despite advances in treatment which have resulted in reductions in morbidity and mortality, heart failure remains a common condition often associated with a poor outcome. In most patients with chronic congestive heart failure, symptoms are not present at rest but become limiting with exertion. Despite this, the majority of measures used to characterise the severity of heart failure and prognosis are obtained at rest.
The New York Heart Association (NYHA) classification attempts to stratify patients according to their exercise limitation, but has a limited relation to objective measures of exercise tolerance and is a very subjective measure of disability. Self administered questionnaires which attempt to assess activity and exercise limitation are unable to measure functional capacity accurately and have only modest correlation with objective parameters such as peak oxygen uptake (p
O2).
Making the diagnosis of heart failure can be difficult. Signs and symptoms lack both sensitivity
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