Assessment of Functional Capacity in Clinical and Research Settings A Scientific Statement From the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing
Ross Arena,Jonathan N. Myers,Mark A. Williams,Martha Gulati,Paul Kligfield,Gary J. Balady,Eileen Collins,Gerald F. Fletcher +7 more
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This scientific statement, an update of the previously published American Heart Association (AHA) document, highlights the major clinical and research applications of functional capacity assessment.Abstract:
The assessment of functional capacity reflects the ability to perform activities of daily living that require sustained aerobic metabolism. The integrated efforts and health of the pulmonary, cardiovascular, and skeletal muscle systems dictate an individual’s functional capacity. Numerous investigations have demonstrated that the assessment of functional capacity provides important diagnostic and prognostic information in a wide variety of clinical and research settings. This scientific statement, an update of the previously published American Heart Association (AHA) document,1 highlights the major clinical and research applications of functional capacity assessment. For a comprehensive review of exercise testing, the reader is referred to the American College of Cardiology (ACC)/AHA Guidelines for Exercise Testing.2,3
Functional capacity is the ability of an individual to perform aerobic work as defined by the maximal oxygen uptake (Vo2max), that is, the product of cardiac output and arteriovenous oxygen (a−Vo2) difference at physical exhaustion, as shown in the following equation: ![Formula][1]
Where HR indicates heart rate and SV indicates stroke volume.
Because Vo2max typically is achieved by exercise that involves only about half of the total body musculature, it is generally believed that Vo2max is limited by maximal cardiac output rather than peripheral factors.4
Although Vo2max is measured in liters of oxygen per minute, it usually is expressed in milliliters of oxygen per kilogram of body weight per minute to facilitate intersubject comparisons. In addition, functional capacity, particularly when estimated from the work rate achieved rather than directly measured Vo, is frequently expressed in metabolic equivalents (METs), with 1 MET representing the resting energy expenditure (≈3.5 mL O2 · kg−1 · min−1). In this instance, functional capacity is commonly expressed clinically as a multiple of the resting metabolic rate.
Vo2max …
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Journal ArticleDOI
Exercise Standards for Testing and Training A Scientific Statement From the American Heart Association
Gerald F. Fletcher,Philip A. Ades,Paul Kligfield,Ross Arena,Gary J. Balady,Vera Bittner,Lola A. Coke,Jerome L. Fleg,Daniel E. Forman,Thomas C. Gerber,Martha Gulati,Kushal Madan,Jonathan Rhodes,Paul D. Thompson,Mark A. Williams +14 more
TL;DR: These guidelines are a revision of the 1995 standards of the AHA that addressed the issues of exercise testing and training and current issues of practical importance in the clinical use of these standards are considered.
Journal ArticleDOI
Clinician’s Guide to Cardiopulmonary Exercise Testing in Adults A Scientific Statement From the American Heart Association
Gary J. Balady,Ross Arena,Kathy Sietsema,Jonathan N. Myers,Lola A. Coke,Gerald F. Fletcher,Daniel E. Forman,Barry A. Franklin,Marco Guazzi,Martha Gulati,Steven J. Keteyian,Carl J. Lavie,Richard Macko,Donna Mancini,Richard V. Milani +14 more
TL;DR: CPX offers the clinician the ability to obtain a wealth of information beyond standard exercise electrocardiography testing that when appropriately applied and interpreted is underutilized by the practicing clinician.
Journal ArticleDOI
Clinical Recommendations for Cardiopulmonary Exercise Testing Data Assessment in Specific Patient Populations
Marco Guazzi,Volker Adams,Viviane M. Conraads,Martin Halle,Alessandro Mezzani,Luc Vanhees,Ross Arena,Gerald F. Fletcher,Daniel E. Forman,Dalane W. Kitzman,Carl J. Lavie,Carl J. Lavie,Jonathan Myers +12 more
TL;DR: The primary target audience of this position paper is clinicians who have limited orientation with CPX but whose caregiving would be enhanced by familiarity and application of this assessment, and a series of forms designed to highlight the utility of CPX in clinical decision-making.
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Mortality trends in the general population: the importance of cardiorespiratory fitness
TL;DR: Based on the evidence, health professionals should encourage their patients to improve CRF through regular physical activity and several biological mechanisms suggest that CRF improves insulin sensitivity, blood lipid profile, body composition, inflammation, and blood pressure.
Journal ArticleDOI
Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: A Policy Statement from the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology
Massimo F Piepoli,Ugo Corrà,Stamatis Adamopoulos,Werner Benzer,Birna Bjarnason-Wehrens,Margaret Cupples,Paul Dendale,Patrick Doherty,Dan Gaita,Stefan Höfer,Hannah McGee,Miguel Mendes,Josef Niebauer,Nana Pogosova,Esteban Garcia-Porrero,Bernhard Rauch,Jean-Paul Schmid,Pantaleo Giannuzzi +17 more
TL;DR: The aims that the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation has foreseen are to promote secondary preventive cardiology in clinical practice.
References
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TL;DR: In this paper, the authors discuss the benefits and risks associated with physical activity and propose a general principles of exercise prescription for healthy populations with special consideration and environmental consideration, as well as a prescription for patients with chronic diseases and health conditions.
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ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease
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TL;DR: This document summarizes current capabilities, research and operational priorities, and plans for further studies that were established at the 2015 USGS workshop on quantitative hazard assessments of earthquake-triggered landsliding and liquefaction.
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Cardiac Resynchronization in Chronic Heart Failure
William T. Abraham,Westby G. Fisher,Andrew L. Smith,David B. Delurgio,Angel R. Leon,Evan Loh,Dusan Z. Kocovic,Milton Packer,Alfredo L. Clavell,David L. Hayes,Myrvin H. Ellestad,Robin J. Trupp,Jackie Underwood,Faith Pickering,Cindy Truex,Peggy McAtee,John C. Messenger +16 more
TL;DR: Cardiac resynchronization results in significant clinical improvement in patients who have moderate-to-severe heart failure and an intraventricular conduction delay.
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ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure).
TL;DR: The American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines regularly reviews existing guidelines to determine when an update or full revision is needed.
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