Non-invasive predictors of functional capacity in patients with systolic heart failure

ABSTRACT

Heart failure [HF] is a major health problem facing the population and development all over the world. Selection of patients with heart failure that are at higher risk and in need for more aggressive and interventional modalities in treatment is needed to improve the outcome of HF patients. The functional capacity of HF patients is a good indicator of the patients' clinical status and response to therapy. Therefore, non-invasive predictors of the functional capacity in patients with HF will be useful in determining patients with low functional capacity, worse clinical status and thus at higher risk. 51 patients of either sex, aged 18 years or above attending Suez Canal University Hospital Cardiology outpatient clinic known to have depressed left ventricular [LV] systolic function "Ejection fraction [EF] patients' NYHA class was estimated. All patients had a 6-minute walking test [6MWT], a 24 hours Holter monitoring, and an echocrdiograhic assessment [including LVEF, Myocardial Performance Index [MPI] and Mitral valve Deceleration Time [DT] done. Heart rate variability [HRV] time domain measurements [SDNN, SDANN, rMSSD] were significantly negatively correlated [at p<0.001] to the patients' functional capacity assessed y NYHA class r=0.52, 0.52, 0.49 respectively] and positively correlated [at p<0.001] with the distance covered in the 6MWT [r=0.96, 0.98, 0.96 respectively], the functional capacity in HF patients. HRV time domain measurements [SDNN, SDANN, rMSSD] are good predictors of patients' functional capacity and can be successfully used to assess the clinical status of the patients. On the contrary, LVEF, MPI and DT showed no correlation with the patients functional capacity and hence, could not be used to assess the clinical status of HF patients