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
This article has been cited by other articles:
 |
|
 |
|
  K. Yoshikawa, S. Fukunaga, K. Arinaga, H. Hori, E. Nakamura, T. Ueda, E. Tayama, and S. Aoyagi Long-Term Results of Aortic Valve Replacement With a Small St. Jude Medical Valve in Japanese Patients Ann. Thorac. Surg., April 1, 2008; 85(4): 1303 - 1308. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Sitbon, C. Lascoux-Combe, J.-F. Delfraissy, P. G. Yeni, F. Raffi, D. De Zuttere, V. Gressin, P. Clerson, D. Sereni, and G. Simonneau Prevalence of HIV-related Pulmonary Arterial Hypertension in the Current Antiretroviral Therapy Era Am. J. Respir. Crit. Care Med., January 1, 2008; 177(1): 108 - 113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, J. R. Kersten, et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery J. Am. Coll. Cardiol., October 23, 2007; 50(17): e159 - e242. [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, J. R. Kersten, et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Circulation, October 23, 2007; 116(17): e418 - e500. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Noda, H. Izawa, H. Asano, S. Nakata, A. Hirashiki, Y. Murase, S. Iino, K. Nagata, T. Murohara, Y. Koike, et al. Beneficial Effect of Bilevel Positive Airway Pressure on Left Ventricular Function in Ambulatory Patients With Idiopathic Dilated Cardiomyopathy and Central Sleep Apnea-Hypopnea: A Preliminary Study Chest, June 1, 2007; 131(6): 1694 - 1701. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. N. Wijeysundera, K. Karkouti, J.-Y. Dupuis, V. Rao, C. T. Chan, J. T. Granton, and W. S. Beattie Derivation and Validation of a Simplified Predictive Index for Renal Replacement Therapy After Cardiac Surgery JAMA, April 25, 2007; 297(16): 1801 - 1809. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Raphael, C. Briscoe, J. Davies, Z. Ian Whinnett, C. Manisty, R. Sutton, J. Mayet, and D. P Francis Limitations of the New York Heart Association functional classification system and self-reported walking distances in chronic heart failure Heart, April 1, 2007; 93(4): 476 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Ammar, S. J. Jacobsen, D. W. Mahoney, J. A. Kors, M. M. Redfield, J. C. Burnett Jr, and R. J. Rodeheffer Prevalence and Prognostic Significance of Heart Failure Stages: Application of the American College of Cardiology/American Heart Association Heart Failure Staging Criteria in the Community Circulation, March 27, 2007; 115(12): 1563 - 1570. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Boyd, C. O. Weiss, J. Halter, K. C. Han, W. B. Ershler, and L. P. Fried Framework for Evaluating Disease Severity Measures in Older Adults With Comorbidity J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2007; 62(3): 286 - 295. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. R. Zacharski, B. K. Chow, P. S. Howes, G. Shamayeva, J. A. Baron, R. L. Dalman, D. J. Malenka, C. K. Ozaki, and P. W. Lavori Reduction of Iron Stores and Cardiovascular Outcomes in Patients With Peripheral Arterial Disease: A Randomized Controlled Trial JAMA, February 14, 2007; 297(6): 603 - 610. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Junghans, G. Feder, A. D. Timmis, S. Eldridge, N. Sekhri, N. Black, P. Shekelle, and H. Hemingway Effect of Patient-Specific Ratings vs Conventional Guidelines on Investigation Decisions in Angina: Appropriateness of Referral and Investigation in Angina (ARIA) Trial Arch Intern Med, January 22, 2007; 167(2): 195 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. N. Singh, X. C. Tang, B. N. Singh, P. Dorian, D. J. Reda, C. L. Harris, R. D. Fletcher, S. C. Sharma, J. E. Atwood, A. K. Jacobson, et al. Quality of Life and Exercise Performance in Patients in Sinus Rhythm Versus Persistent Atrial Fibrillation: A Veterans Affairs Cooperative Studies Program Substudy J. Am. Coll. Cardiol., August 15, 2006; 48(4): 721 - 730. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. G. Koenig, J. Vandermeer, A. Chambers, L. Burr-Crutchfield, and J. L. Johnson Comparison of Major and Minor Depression in Older Medical Inpatients With Chronic Heart and Pulmonary Disease Psychosomatics, August 1, 2006; 47(4): 296 - 303. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. G. Koenig Depression outcome in inpatients with congestive heart failure. Arch Intern Med, May 8, 2006; 166(9): 991 - 996. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Redfield, S. J. Jacobsen, B. A. Borlaug, R. J. Rodeheffer, and D. A. Kass Age- and Gender-Related Ventricular-Vascular Stiffening: A Community-Based Study Circulation, October 11, 2005; 112(15): 2254 - 2262. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Kaehler, R. Koester, W. Billmann, C. Schroeder, H.-J. Rupprecht, T. Ischinger, R. Jahns, A. Vogt, M. Lampen, R. Hoffmann, et al. 13-year follow-up of the German angioplasty bypass surgery investigation Eur. Heart J., October 2, 2005; 26(20): 2148 - 2153. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Jimenez-Candil, J Bermejo, R Yotti, C Cortina, M Moreno, J L Cantalapiedra, and M A Garcia-Fernandez Effects of angiotensin converting enzyme inhibitors in hypertensive patients with aortic valve stenosis: a drug withdrawal study Heart, October 1, 2005; 91(10): 1311 - 1318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Das, H. Rimington, and J. Chambers Exercise testing to stratify risk in aortic stenosis Eur. Heart J., July 1, 2005; 26(13): 1309 - 1313. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Utriyaprasit and S. Moore Recovery Symptoms and Mood States in Thai CABG patients J Transcult Nurs, April 1, 2005; 16(2): 97 - 106. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Penckofer, C. E. Ferrans, N. Fink, M. L. Barrett, and K. Holm Quality of Life in Women Following Coronary Artery Bypass Graft Surgery Nurs Sci Q, April 1, 2005; 18(2): 176 - 183. [Abstract] [PDF]
|
|
|
|
 |
|
 T. E. Meyer, M. Karamanoglu, A. A. Ehsani, and S. J. Kovacs Left ventricular chamber stiffness at rest as a determinant of exercise capacity in heart failure subjects with decreased ejection fraction J Appl Physiol, November 1, 2004; 97(5): 1667 - 1672. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Di Bari, C. Pozzi, M. C. Cavallini, F. Innocenti, G. Baldereschi, W. De Alfieri, E. Antonini, R. Pini, G. Masotti, and N. Marchionni The diagnosis of heart failure in the community: Comparative validation of four sets of criteria in unselected older adults: the ICARe Dicomano Study J. Am. Coll. Cardiol., October 19, 2004; 44(8): 1601 - 1608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. R. Perna, S. M. Macin, J. P. C. Canella, N. Augier, J. L. R. Stival, J. R. Cialzeta, A. E. Pitzus, E. H. Garcia, R. Obregon, M. Brizuela, et al. Ongoing Myocardial Injury in Stable Severe Heart Failure: Value of Cardiac Troponin T Monitoring for High-Risk Patient Identification Circulation, October 19, 2004; 110(16): 2376 - 2382. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Link, A. S. Hellkamp, N. A. M. Estes III, E. J. Orav, K. A. Ellenbogen, B. Ibrahim, A. Greenspon, C. Rizo-Patron, L. Goldman, K. L. Lee, et al. High incidence of pacemaker syndrome in patients with sinus node dysfunction treated with ventricular-based pacing in the Mode Selection Trial (MOST) J. Am. Coll. Cardiol., June 2, 2004; 43(11): 2066 - 2071. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. V. Sneed and S. C. Paul Readiness for Behavioral Changes in Patients With Heart Failure Am. J. Crit. Care., September 1, 2003; 12(5): 444 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Rubartelli, E. Verna, L. Niccoli, C. Giachero, M. Zimarino, G. Bernardi, C. Vassanelli, L. Campolo, E. Martuscelli, and Gruppo Italiano di Studio sullo Stent nelle Occlus Coronary stent implantation is superior to balloon angioplasty for chronic coronary occlusions: Six-year clinical follow-up of the GISSOC trial J. Am. Coll. Cardiol., May 7, 2003; 41(9): 1488 - 1492. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Boriani, M. Gallina, L. Merlini, G. Bonne, D. Toniolo, S. Amati, M. Biffi, C. Martignani, L. Frabetti, M. Bonvicini, et al. Clinical Relevance of Atrial Fibrillation/Flutter, Stroke, Pacemaker Implant, and Heart Failure in Emery-Dreifuss Muscular Dystrophy: A Long-Term Longitudinal Study Stroke, April 1, 2003; 34(4): 901 - 908. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H. Cole, J. I. Miller III, L. S. Sperling, and W. S. Weintraub Long-term follow-up of coronary artery disease presenting in young adults J. Am. Coll. Cardiol., February 19, 2003; 41(4): 521 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. H. Hulzebos, N. L. Van Meeteren, R. A De Bie, P. C Dagnelie, and P. J. Helders Prediction of Postoperative Pulmonary Complications on the Basis of Preoperative Risk Factors in Patients Who Had Undergone Coronary Artery Bypass Graft Surgery Physical Therapy, January 1, 2003; 83(1): 8 - 16. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H. Cole, E. L. Jones, J. M. Craver, R. A. Guyton, D. C. Morris, J. S. Douglas Jr, Z. Ghazzal, and W. S. Weintraub Outcomes of repeat revascularization in diabetic patients with prior coronary surgery J. Am. Coll. Cardiol., December 4, 2002; 40(11): 1968 - 1975. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Weber-Mzell, P. Kotanko, M. Schumacher, W. Klein, and F. Skrabal Coronary anatomy predicts presence or absence of renal artery stenosis. A prospective study in patients undergoing cardiac catheterization for suspected coronary artery disease Eur. Heart J., November 1, 2002; 23(21): 1684 - 1691. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Medow, H. G. Weed, and D. E. Schuller Simple Predictors of Survival in Head and Neck Squamous Cell Carcinoma Arch Otolaryngol Head Neck Surg, November 1, 2002; 128(11): 1282 - 1286. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Fernandez-Sola, J. M. Nicolas, J. Oriola, E. Sacanella, R. Estruch, E. Rubin, and A. Urbano-Marquez Angiotensin-Converting Enzyme Gene Polymorphism Is Associated with Vulnerability to Alcoholic Cardiomyopathy Ann Intern Med, September 3, 2002; 137(5_Part_1): 321 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A. Mangoni, T. M. Koelling, G. S. Meyer, C. W. Akins, and M. A. Fifer Outcome following mitral valve replacement in patients with mitral stenosis and moderately reduced left ventricular ejection fraction Eur. J. Cardiothorac. Surg., July 1, 2002; 22(1): 90 - 94. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. A. Lamas, K. L. Lee, M. O. Sweeney, R. Silverman, A. Leon, R. Yee, R. A. Marinchak, G. Flaker, E. Schron, E. J. Orav, et al. Ventricular Pacing or Dual-Chamber Pacing for Sinus-Node Dysfunction N. Engl. J. Med., June 13, 2002; 346(24): 1854 - 1862. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Taccetta-Chapnick Using Carvedilol to Treat Heart Failure Crit. Care Nurse, April 1, 2002; 22(2): 36 - 58. [Full Text] [PDF]
|
|
|
|
|
|
B. Riegel, B. Carlson, Z. Kopp, B. LePetri, D. Glaser, and A. Unger Effect of a Standardized Nurse Case-Management Telephone Intervention on Resource Use in Patients With Chronic Heart Failure Arch Intern Med, March 25, 2002; 162(6): 705 - 712. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Eagle, P. B. Berger, H. Calkins, B. R. Chaitman, G. A. Ewy, K. E. Fleischmann, L. A. Fleisher, J. B. Froehlich, R. J. Gusberg, J. A. Leppo, et al. ACC/AHA Guideline Update for Perioperative Cardiovascular Evaluation for Noncardiac Surgery--Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Circulation, March 12, 2002; 105(10): 1257 - 1267. [Full Text] [PDF]
|
|
|
|
|
|
K. A. Eagle, P. B. Berger, H. Calkins, B. R. Chaitman, G. A. Ewy, K. E. Fleischmann, L. A. Fleisher, J. B. Froehlich, R. J. Gusberg, J. A. Leppo, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery--executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) J. Am. Coll. Cardiol., February 6, 2002; 39(3): 542 - 553. [Full Text] [PDF]
|
|
|
|
|
|
J. M. Nicolas, J. Fernandez-Sola, R. Estruch, J. C. Pare, E. Sacanella, A. Urbano-Marquez, and E. Rubin The Effect of Controlled Drinking in Alcoholic Cardiomyopathy Ann Intern Med, February 5, 2002; 136(3): 192 - 200. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Omoto, K. Minami, D. Varvaras, D. Bothig, and R. Korfer Radical Pericardiectomy for Chronic Constrictive Pericarditis Asian Cardiovasc Thorac Ann, December 1, 2001; 9(4): 286 - 290. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. V. Guimaraes, G. Bellotti, A. O. Mocelin, P. R. Camargo, and E. A. Bocchi Cardiopulmonary Exercise Testing in Children With Heart Failure Secondary to Idiopathic Dilated Cardiomyopathy Chest, September 1, 2001; 120(3): 816 - 824. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Polanczyk, L. E. Rohde, L. Goldman, E. F. Cook, E. J. Thomas, E. R. Marcantonio, C. M. Mangione, and T. H. Lee Right Heart Catheterization and Cardiac Complications in Patients Undergoing Noncardiac Surgery: An Observational Study JAMA, July 18, 2001; 286(3): 309 - 314. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Chello, P. Mastroroberto, F. Perticone, F. Cirillo, E. Bevacqua, S. Olivito, and E. Covino Plasma levels of atrial and brain natriuretic peptides as indicators of recovery of left ventricular systolic function after coronary artery bypass Eur. J. Cardiothorac. Surg., July 1, 2001; 20(1): 140 - 146. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Kiemeneij, P. W. Serruys, C. Macaya, W. Rutsch, G. Heyndrickx, P. Albertsson, J. Fajadet, V. Legrand, P. Materne, J. Belardi, et al. Continued benefit of coronary stenting versus balloon angioplasty: five-year clinical follow-up of Benestent-I trial J. Am. Coll. Cardiol., May 1, 2001; 37(6): 1598 - 1603. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Castaño, R. Más, J.C. Fernández, J. Illnait, L. Fernández, and E. Alvarez Effects of Policosanol in Older Patients With Type II Hypercholesterolemia and High Coronary Risk J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2001; 56(3): 186M - 193. [Abstract] [Full Text]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
Recommendations for exercise testing in chronic heart faliure patients Eur. Heart J., January 1, 2001; 22(1): 37 - 45. [PDF]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 G. B. Luciani, G. Montalbano, G. Casali, and A. Mazzucco Predicting long-term functional results after myocardial revascularization in ischemic cardiomyopathy J. Thorac. Cardiovasc. Surg., September 1, 2000; 120(3): 478 - 489. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
G. Guyatt A 75-Year-Old Man With Congestive Heart Failure JAMA, June 23, 1999; 281(24): 2321 - 2328. [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|