Circulation, Vol 64, 1227-1234, Copyright © 1981 by American Heart Association
L Goldman, B Hashimoto, EF Cook and A Loscalzo
Reproducibility and validity are prerequisites for a useful clinical scale.
We therefore prospectively tested the reproducibility and validity of the
New York Heart Association criteria and the Canadian Cardiovascular Society
criteria for the assessment of cardiac functional class and compared these
criteria with a new Specific Activity Scale based on the metabolic costs of
specific activities. The New York Heart Association estimates made by two
physicians had a reproducibility of only 56%, and only 51% of the estimates
agreed with treadmill exercise performance. Functional estimates based on
the Canadian Cardiovascular Society criteria were significantly more
reproducible (73%), but not significantly more valid. The Specific Activity
Scale was as reproducible as the Canadian Cardiovascular Society criteria,
and its 68% validity was significantly higher than the validities of the
other systems. The easily administered Specific Activity Scale was equally
reproducible and valid when used by a nonphysician. It was especially
better than the other systems for the evaluation of true class II patients
and was significantly less likely to underestimate treadmill performance.
Although no set of questions can perfectly predict exercise tolerance, the
Specific Activity Scale deserves wider prospective testing.
ARTICLES
Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale
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S. Volpato, J. M. Guralnik, L. Ferrucci, J. Balfour, P. Chaves, L. P. Fried, and T. B. Harris Cardiovascular Disease, Interleukin-6, and Risk of Mortality in Older Women : The Women's Health and Aging Study Circulation, February 20, 2001; 103(7): 947 - 953. [Abstract] [Full Text] [PDF]
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M. Gomberg-Maitland, D. A. Baran, and V. Fuster Treatment of Congestive Heart Failure: Guidelines for the Primary Care Physician and the Heart Failure Specialist Arch Intern Med, February 12, 2001; 161(3): 342 - 352. [Abstract] [Full Text] [PDF]
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Recommendations for exercise testing in chronic heart faliure patients Eur. Heart J., January 1, 2001; 22(1): 37 - 45. [PDF]
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P. Dorian, W. Jung, D. Newman, M. Paquette, K. Wood, G. M. Ayers, J. Camm, M. Akhtar, and B. Luderitz The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy J. Am. Coll. Cardiol., October 1, 2000; 36(4): 1303 - 1309. [Abstract] [Full Text] [PDF]
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C. Rostagno, G. Galanti, M. Comeglio, V. Boddi, G. Olivo, and G. G. N. Serneri Comparison of different methods of functional evaluation in patients with chronic heart failure Eur J Heart Fail, September 1, 2000; 2(3): 273 - 280. [Abstract] [Full Text] [PDF]
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N Suskin, R.S McKelvie, R.J Burns, R Latini, D Pericak, J Probstfield, J.L Rouleau, C Sigouin, C.B Solymoss, R Tsuyuki, et al. Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure Eur. Heart J., August 2, 2000; 21(16): 1368 - 1375. [Abstract] [PDF]
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C J O'Leary and P W Jones The left ventricular dysfunction questionnaire (LVD-36): reliability, validity, and responsiveness Heart, June 1, 2000; 83(6): 634 - 640. [Abstract] [Full Text]
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H. G. Weed, D. Reilly, and S. D. Fihn Identifying High-Risk Surgical Patients by Poor Self-Reported Exercise Tolerance Arch Intern Med, May 22, 2000; 160(10): 1539 - 1539. [Full Text] [PDF]
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G. Guyatt A 75-Year-Old Man With Congestive Heart Failure JAMA, June 23, 1999; 281(24): 2321 - 2328. [Full Text] [PDF]
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J Herlitz, I Wiklund, K Caidahl, B W Karlson, H Sjöland, M Hartford, M Haglid, and T Karlsson Determinants of an impaired quality of life five years after coronary artery bypass surgery Heart, April 1, 1999; 81(4): 342 - 346. [Abstract] [Full Text]
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M. Brignole, C. Menozzi, L. Gianfranchi, G. Musso, R. Mureddu, N. Bottoni, and G. Lolli Assessment of Atrioventricular Junction Ablation and VVIR Pacemaker Versus Pharmacological Treatment in Patients With Heart Failure and Chronic Atrial Fibrillation : A Randomized, Controlled Study Circulation, September 8, 1998; 98(10): 953 - 960. [Abstract] [Full Text] [PDF]
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T. A Abdel Aziz, N. Al Khaja, M. A Ali, A. S Maklad, M. F Bassiouny, M. Turner, and D. G Roberts Antegrade-Retrograde Cardioplegia for Myocardial Protection During Coronary Artery Bypass Graft Surgery Asian Cardiovasc Thorac Ann, September 1, 1998; 6(3): 188 - 194. [Abstract] [Full Text] [PDF]
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H. M. Krumholz, R. S. Phillips, M. B. Hamel, J. M. Teno, P. Bellamy, S. K. Broste, R. M. Califf, H. Vidaillet, R. B. Davis, L. H. Muhlbaier, et al. Resuscitation Preferences Among Patients With Severe Congestive Heart Failure : Results From the SUPPORT Project Circulation, August 18, 1998; 98(7): 648 - 655. [Abstract] [Full Text] [PDF]
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G. A. Lamas, E. J. Orav, B. S. Stambler, K. A. Ellenbogen, E. B. Sgarbossa, S. K. S. Huang, R. A. Marinchak, N.A. M. Estes, G. F. Mitchell, E. H. Lieberman, et al. Quality of Life and Clinical Outcomes in Elderly Patients Treated with Ventricular Pacing as Compared with Dual-Chamber Pacing N. Engl. J. Med., April 16, 1998; 338(16): 1097 - 1104. [Abstract] [Full Text] [PDF]
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C. A. Schneider, E. Voth, F. M. Baer, M. Horst, R. Wagner, and U. Sechtem QT Dispersion Is Determined by the Extent of Viable Myocardium in Patients With Chronic Q-Wave Myocardial Infarction Circulation, December 2, 1997; 96(11): 3913 - 3920. [Abstract] [Full Text]
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F. E. Marchlinski Predicting Arrhythmic Death : A Plea for Standardized Reporting Techniques and Data Based on Continuous Electrocardiographic Monitoring Circulation, September 16, 1997; 96(6): 1713 - 1716. [Full Text]
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A. C. Caruso, F. I. Marcus, E. A. Hahn, V. L. Hartz, and J. W. Mason Predictors of Arrhythmic Death and Cardiac Arrest in the ESVEM Trial Circulation, September 16, 1997; 96(6): 1888 - 1892. [Abstract] [Full Text]
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R. K. M. Chan, J. Raman, K. J. Lee, A. Rosalion, R. J. Hicks, S. Pornvilawan, B. S. T. Sia, J. D. Horowitz, A. M. Tonkin, and B. F. Buxton Prediction of Outcome After Revascularization in Patients With Poor Left Ventricular Function Ann. Thorac. Surg., May 1, 1996; 61(5): 1428 - 1434. [Abstract] [Full Text]
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T. K. Kaul, A. K. Agnihotri, B. L. Fields, L. S. Riggins, D. A. Wyatt, and C. R. Jones CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH AN EJECTION FRACTION OF TWENTY PERCENT OR LESS J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 1001 - 1012. [Abstract] [Full Text]
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M. F. Di Carli, F. Asgarzadie, H. R. Schelbert, R. C. Brunken, H. Laks, M. E. Phelps, and J. Maddahi Quantitative Relation Between Myocardial Viability and Improvement in Heart Failure Symptoms After Revascularization in Patients With Ischemic Cardiomyopathy Circulation, December 15, 1995; 92(12): 3436 - 3444. [Abstract] [Full Text]
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P. W. Serruys, J.-P. R. Herrman, R. Simon, W. Rutsch, C. Bode, G.-J. Laarman, R. van Dijk, A. A. van den Bos, V. A.W.M. Umans, K. A.A. Fox, et al. A Comparison of Hirudin with Heparin in the Prevention of Restenosis after Coronary Angioplasty N. Engl. J. Med., September 21, 1995; 333(12): 757 - 764. [Abstract] [Full Text] [PDF]
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E. Guadagnoli, P. J. Hauptman, J. Z. Ayanian, C. L. Pashos, B. J. McNeil, and P. D. Cleary Variation in the Use of Cardiac Procedures after Acute Myocardial Infarction N. Engl. J. Med., August 31, 1995; 333(9): 573 - 578. [Abstract] [Full Text] [PDF]
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Effects of Carvedilol, a Vasodilator–ß-Blocker, in Patients With Congestive Heart Failure Due to Ischemic Heart Disease Circulation, July 15, 1995; 92(2): 212 - 218. [Abstract] [Full Text]
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M. B. Hamel, L. Goldman, J. Teno, J. Lynn, R. B. Davis, F. E. Harrell Jr, A. F. Connors Jr, R. Califf, P. Kussin, P. Bellamy, et al. Identification of Comatose Patients at High Risk for Death or Severe Disability JAMA, June 21, 1995; 273(23): 1842 - 1848. [Abstract] [PDF]
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M. A. Hlatky Patient Preferences and Clinical Guidelines JAMA, April 19, 1995; 273(15): 1219 - 1220. [Abstract] [PDF]
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D. R. Jones, H. E. Warden, G. F. Murray, R. C. Hill, G. M. Graeber, J. L. Cruzzavala, R. A. Gustafson, and A. Vasilakis Biatrial Approach to Cardiac Myxomas: A 30-Year Clinical Experience Ann. Thorac. Surg., April 1, 1995; 59(4): 851 - 856. [Abstract] [Full Text]
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M. J. Reiter, D. E. Mann, J. E. Reiffel, E. Hahn, and V. Hartz Significance and Incidence of Concordance of Drug Efficacy Predictions by Holter Monitoring and Electrophysiological Study in the ESVEM Trial Circulation, April 1, 1995; 91(7): 1988 - 1995. [Abstract] [Full Text]
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E. R. Marcantonio, G. Juarez, L. Goldman, C. M. Mangione, L. E. Ludwig, L. Lind, N. Katz, E. F. Cook, E. J. Orav, and T. H. Lee The Relationship of Postoperative Delirium With Psychoactive Medications JAMA, November 16, 1994; 272(19): 1518 - 1522. [Abstract] [PDF]
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B. D. Williamson, K. C. Man, E. Daoud, M. Niebauer, S. A. Strickberger, and F. Morady Radiofrequency Catheter Modification of Atrioventricular Conduction to Control the Ventricular Rate during Atrial Fibrillation N. Engl. J. Med., October 6, 1994; 331(14): 910 - 917. [Abstract] [Full Text]
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