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| (A) New York Heart Association functional classification |
| (i) Class 1: no symptoms with ordinary physical activity |
| (ii) Class 2: symptoms with ordinary activity; slight limitation of activity |
| (iii) Class 3: symptoms with less than ordinary activity; marked limitation of activity |
| (iv) Class 4: symptoms with any activity or even at rest |
| (B) WHO functional assessment classification |
| (i) Class I: patients with PH but without resulting limitation of physical activity; ordinary physical activity does not cause undue |
| dyspnea or fatigue, chest pain, or near syncopy |
| (ii) Class II: patients with PH resulting in slight limitation of physical activity; they are comfortable at rest; ordinary physical |
| activity causes undue dyspenea or fatigue, chest pain, or near syncope |
| (iii) Class III: patients with PH resulting in marked limitation of physical activity; they are comfortable at rest; less than ordinary |
| activity causes undue dyspenea or fatigue, chest pain, or near syncope |
| (iv) Class IV: patients with PH with inability to carry out any physical activity without symptoms; these patients manifest signs of right |
| -heart failure; dyspnea and/or fatigue may even be present at rest; discomfort is increased by any physical activity |
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