Imperial College London
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Professor Konstantinos Dimopoulos

Faculty of Medicine, National Heart & Lung Institute

Professor of Practice (Adult Congenital Heart Disease)
 
 
 
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Contact

 

+44 (0)20 7352 8121 ext 82771k.dimopoulos02

 
 
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Location

 

Chelsea WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Bredy:2017:ehjqcco/qcx031,
author = {Bredy, C and Ministeri, M and Kempny, A and Alonso-Gonzalez, R and Swan, L and Uebing, A and Diller, G-P and Gatzoulis, MA and Dimopoulos, K},
doi = {ehjqcco/qcx031},
journal = {European Heart Journal - Quality of Care and Clinical Outcomes},
pages = {51--58},
title = {NYHA classification in adults with congenital heart disease: Relation to objective measures of exercise and outcome.},
url = {http://dx.doi.org/10.1093/ehjqcco/qcx031},
volume = {4},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AimsThe New York Heart Association functional classification (NYHA class) is often used to describe the functional capacity of adults with congenital heart disease (ACHD), albeit with limited evidence on its validity in this heterogeneous population. We aimed to validate the NYHA functional classification in ACHD by examining its relation to objective measures of limitation using cardiopulmonary exercise testing (CPET) and mortality.Methods and resultsThis study included all ACHD patients who underwent a CPET between 2005 and 2015 at the Royal Brompton, in whom functional capacity was graded according to the NYHA classification. Congenital heart diagnoses were classified according to the Bethesda score. Time to all-cause mortality from CPET was recorded in all 2781 ACHD patients (mean age 33.8 ± 14.2 years) enrolled in the study. There was a strong relation between NYHA class and peak oxygen consumption (peak VO2), ventilation per unit in carbon dioxide production (VE/VCO2) slope and the Bethesda classification (P < 0.0001). Although a large number of ‘asymptomatic’ (NYHA class 1) patients did not achieve a ‘normal’ peak VO2, the NYHA class was a strong predictor of mortality, with an 8.7-fold increased mortality risk in class 3 compared with class 1 (hazard ratio 8.68, 95% confidence interval: 5.26–14.35, P < 0.0001).ConclusionDespite underestimating the degree of limitation in some ACHD patients, NYHA classification remains a valuable clinical tool. It correlates with objective measures of exercise and the severity of underlying cardiac disease, as well as mid- to long-term mortality and should, thus, be into incorporated the routine assessment and risk stratification of these patients.
AU  - Bredy,C
AU  - Ministeri,M
AU  - Kempny,A
AU  - Alonso-Gonzalez,R
AU  - Swan,L
AU  - Uebing,A
AU  - Diller,G-P
AU  - Gatzoulis,MA
AU  - Dimopoulos,K
DO  - ehjqcco/qcx031
EP  - 58
PY  - 2017///
SN  - 2058-5225
SP  - 51
TI  - NYHA classification in adults with congenital heart disease: Relation to objective measures of exercise and outcome.
T2  - European Heart Journal - Quality of Care and Clinical Outcomes
UR  - http://dx.doi.org/10.1093/ehjqcco/qcx031
UR  - http://hdl.handle.net/10044/1/52115
VL  - 4
ER  -
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