Document Detail


Six-minute walk test and cardiopulmonary exercise testing in patients with chronic heart failure: a comparative analysis on clinical and prognostic insights.
MedLine Citation:
PMID:  19919979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The six-minute walk test (6MWT) and cardiopulmonary exercise testing (CPET) are the 2 testing modalities most broadly used for assessing functional limitation in patients with heart failure (HF). A comprehensive comparison on clinical and prognostic validity of the 2 techniques has not been performed and is the aim of the present investigation. METHODS AND RESULTS: Two hundred fifty-three patients diagnosed with systolic (n=211) or diastolic (n=42) HF (age: 61.9+/-10.1 years; New York Heart Association Class: 2.2+/-0.78) underwent a 6MWT and a symptom-limited CPET evaluation and were prospectively followed up. During the 4-year tracking period, there were 43 cardiac-related deaths with an annual cardiac mortality rate of 8.7%. The 6MWT distance correlated with CPET-derived variables (ie, peak Vo(2), Vo(2) at anaerobic threshold, and Ve/Vco(2) slope) and was significantly reduced in proportion with lower peak Vo(2) and higher Ve/Vco(2) slope classes and presence of an exercise oscillatory breathing (EOB) pattern (P<0.01). However, no significant differences were observed in distance covered between survivors and nonsurvivors (353.2+/-95.8 m versus 338.5+/-76.4 m; P=NS). At univariate and multivariate Cox proportional analyses, the association of the 6MWT distance with survival was not significant either as a continuous or dicotomized variable (< or =300 m). Conversely, CPET-derived variables emerged as prognostic with the strongest association found for EOB (systolic HF) and Ve/Vco(2) slope (entire population with HF and patients with a 6MWT< or =300 m). CONCLUSIONS: The 6MWT is confirmed to be a simple and reliable first-line test for quantification of exercise intolerance in patients with HF. However, there is no supportive evidence for its use as a prognostic marker in alternative to or in conjunction with CPET-derived variables.
Authors:
Marco Guazzi; Kenneth Dickstein; Marco Vicenzi; Ross Arena
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-28
Journal Detail:
Title:  Circulation. Heart failure     Volume:  2     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-20     Completed Date:  2009-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  549-55     Citation Subset:  IM    
Affiliation:
Cardiopulmonary Unit, University of Milano, Italy. marco.guazzi@unimi.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiovascular System / physiopathology*
Chronic Disease
Electrocardiography
Exercise Test*
Exercise Tolerance*
Female
Follow-Up Studies
Heart Failure, Diastolic / diagnosis*,  mortality,  physiopathology,  therapy
Heart Failure, Systolic / diagnosis*,  mortality,  physiopathology,  therapy
Humans
Male
Middle Aged
Oxygen Consumption
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Reproducibility of Results
Respiratory Function Tests
Respiratory Mechanics
Respiratory System / physiopathology*
Risk Assessment
Severity of Illness Index
Time Factors
Treatment Outcome
Ventricular Function, Left
Walking*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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