Assesment of symptom limited stair climbing test efficacy in chronic heart failure patients

Objective : To assess the efficacy of symptom-limited stair climbing test(SLSCT), in determining exercise capacities of patients with chronic heart failure(CHF) by comparing cardiopulmonary exercise test(CPET) and 6-minute walk test(6DKYT) and to interpret the results according to clinical characteristics of patients. Method: 31 patients aged 50-75 years with stage II-III according to the NYHA classification, diagnosed with CHF, with a left ventricular ejection fraction(LVEF) of 45% or less were included. Demographic and clinical characteristics of the patients were questioned. Exercise capacity was assessed by SLSCT, 6 MWT, CPET. Patient's test time, reasons for ending the test were recorded. The estimated maximal oxygen consumption(VO2 max) of the patients was calculated by means of the formulas used in the literature. Patients physical activity levels were assessed by physical activity assessment questionnaire(PAAQ), dyspnea and effort perception by Modified Borg Scale(MBS) and Modified Medical Research Council Scale(mMRC), depression levels by Hospital Anxiety Depression Scale(HADS), respiratory functions by spirometric measurements, health-related quality of life(HRQOL) by Chronic Heart Failure Questionnaire(CHFQ). Results : It was determined that the test with the highest VO2 max value among the tests was SLSCT. A significant difference was noted between the other tests(p <0.05). In heart rate changes before and after the tests, SLSCT was found to increase heart rate more than 6MWT and less than CPET. A significant correlation was found between the predicted VO2max values of CPET and SLSCTT(r = 0.52, p = 0.003). It was also found that SLSCTT was more related to clinical caacteristics of patients. Conclusion: SLSCTT is effective in evaluating exercise capacity and easy to use in CHF patients. Compared with the 6MWT, it gives better results in determining the clinical characteristics and hemodynamic responses of the patients. It is an alternative to assessing exercise capacity in the absence of CPET.