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[Music] defining new york heart association classification is a subjective process and sometimes is very difficult to do for a variety of reasons but patients dont tell you exactly how they feel they want to be nice and they just give you social greetings or you dont ask the right questions but the most important thing i think for the cardio mm system is that we designed the trial to assess new york heart association class that was predominant over the last 30 days so not what they are in front of you but what have they been in the last 30 days and i typically use some reference like making the bed or vacuuming or walking through the mailbox and back or to a defined amount of exertion sometimes walking into the into the office is important and and then to find out why they um they had to stop if they did or what limits their exertion and and i always remember that fatigue is also a very important component of the new york heart association classification and people many times equate