Functional Assessment of Heart Failure Patients

Heart failure (HF) is the condition characterized by the inability of the heart to pump sufficient blood to meet the demands of the body. It has been well established that both the prevalence and incidence of HF is increasing.1 There are 2 primary types of HF, categorized by ejection fraction: Reduced ejection fraction and preserved ejection fraction.2 Additionally, HF is commonly classified into stages from mild to severe using a symptom-based scale related to functional limitations. One of the hallmark features of HF is exercise intolerance, which is accompanied by symptoms of fatigue and shortness of breath.3 As the disease progresses, patients experience a downward spiral as these symptoms typically result in reduced physical activity, which leads to progressively worsening exercise intolerance. Typically, patients with HF are faced with what can be termed a functional disability. Often, their reduced functional abilities restrict or may even prevent them from performing occupational tasks, which may result in loss of work. Additionally, it is well known that patients with HF experience impairment in the ability to carry out activities of daily living and suffer from reduced quality of life. The objective of this paper was to provide an overview of assessments of functional ability of patients with HF. Two categories of assessment are reviewed: Cardiovascular function and muscular function. The review includes procedural guidance on how to administer the assessments and information related to the advantages and disadvantages of each method. Because both HF types (reduced ejection fraction and preserved ejection fraction) are characterized by exercise intolerance, the procedures can be used effectively with either type of HF