Cor Vasa 2023, 65(Suppl. 3):37-43 | DOI: 10.33678/cor.2023.064

Relationship between Functional Capacity and Medication Adherence in Heart Failure

Libor Jelínek^a, Martin Modrák^b, Zdeněk Ramík^c, Lukáš Štos^c, Luděk Pavlů^d, Jan Václavík^{c, e}, Eliška Sovová^a

^a Department of Exercise Medicine and Cardiovascular Rehabilitation, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc

^b Bioinformatics Core Facility, Institute of Microbiology of the Czech Academy of Sciences, Prague

^c Department of Internal Medicine and Cardiology, University Hospital Ostrava, Ostrava

^d Department of Internal Medicine I - Cardiology, Palacky University and University Hospital Olomouc, Olomouc

^e Faculty of Medicine, University of Ostrava, Ostrava

Introduction: This study investigated the relationship between the subjective New York Heart Association (NYHA) class and objective exercise capacity (VO_2peak) in patients with heart failure and whether it is influenced by medication adherence.

Methods: Data from 170 heart failure patients in the Level-CHF register were analysed, and adherence was assessed by serum drug level testing. Objective exercise capacity was assessed by cardiopulmonary exercise testing using a bicycle ergometer.

Results: Objective VO_2peak frequently exceeded the subjective NYHA class with 46% concordance, especially at the extreme ends of the spectrum. Minor differences in subjective NYHA class in relation to medication adherence were noted, but no substantial disparity was observed.

Conclusion: These findings highlight the discrepancies between subjective and objective assessments of functional capacity in patients with heart failure. This calls for a greater use of objective measurements in clinical decision-making based on functional capacity and for preference of direct VO_2peak values over subjective NYHA categories. Medication adherence did not significantly alter the subjective-objective NYHA trends.

Keywords: Adherence, Cardiopulmonary exercise testing, Chronic heart failure, Drug therapy, Serum drug levels

Received: July 25, 2023; Revised: July 25, 2023; Accepted: August 7, 2023; Published: December 1, 2023  Show citation