To translate, culturally adapt, and validate the Duke Activity Status Index (DASI) to the Pakistani Urdu language. The study will measure the reliability & validity of DASI in the Urdu version.No study has been conducted in the Pakistan region to translate DASI which follows the proper cross-culture adaptation.

Literature suggested that Duke Activity Index (DASI) is a questionnaire originally developed in English To evaluate the functionality. DASI was used primarily to assess patients with cardiovascular diseases such as coronary artery disease, heart failure, myocardial ischemia, and infarction. In clinical practice, DASI can be used to know the effects of medical treatments and cardiac rehabilitation and to assist clinical decisions In controlled clinical trials, DASI can also be used to assess interventions and as a component for assessing the costs/benefits of treatment.

Studies demonstrated that DASI is characterized as a questionnaire with good functional ability, evidence of validity, usefulness, and great clinical and scientific applicability, it seems to be a useful tool for evaluating cardiac patients. So, to be used with Brazilian CVD patients it is necessary to validate DASI and verify its psychometric properties in this population.

Inclusion Criteria:

• Individuals have enough education level to understand Urdu and English as well with a body mass index between 18.6 and 39.9 kg/m with the diagnosis of cardiovascular diseases such as coronary artery disease, valvular heart disease, arrhythmia with at least one symptom11 such as chest pain, palpitations, fatigue, or dyspnea, and physician referral to exercise testing.

Exclusion Criteria:

• Individual is unable to read the questionnaire, who have cognitive deficits screened by Mini-Mental State Examination according to the cut-off points and Hospitalization two months before as well as acute illness, fever, or severe physical limitation that would prevent from doing the exercise test.

To meet inclusion criteria participants will be diagnosed with heart disease, clinically stable, and able to read the Urdu version of DASI. Then patient response will be checked on the translated Urdu version.