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Clinical Investigations: CardiologyThe Six-Minute Walk Test Predicts Peak Oxygen Uptake and Survival in Patients With Advanced Heart Failure
Section snippets
Patient Population
Forty-five patients with advanced, symptomatic heart disease referred to the Massachusetts General Hospital Heart Failure Center for cardiac transplant evaluation comprised the study population. Excluded from the study were patients with neurologic or orthopedic conditions that impaired successful completion of submaximal or maximal exercise testing and patients who exhibited significant anxiety or difficulty in understanding the protocol of exercise testing. Prior to exercise testing, medical
Patient Characteristics
The 45 study patients included 40 men and 5 women; the mean patient age was 49±8 years (Table 1). The cause of heart failure included idiopathic dilated cardiomyopathy in 33 patients (73%), ischemic cardiomyopathy in 10 patients (22%), restrictive cardiomyopathy in 1 patient, and viral myocarditis in 1 patient. Pulmonary function tests showed that the mean FEV1 was 2.82±0.81 L and the FVC was 3.52±0.96 L. The mean left ventricular ejection fraction (LVEF) at rest was 0.20±0.06. The right
DISCUSSION
The results of this study show that distance ambulated during the 6'WT following optimization of medical therapy predicts peak and peak % in patients with advanced chronic heart failure referred for cardiac transplant evaluation. In this small cohort of patients, distance ambulated during the 6'WT less than 300 m also predicted the occurrence of death or hospital admission for inotropic or mechanical bridging to transplantation within the next 6 months. The 6'WT was found to
CONCLUSION
The 6'WT total distance ambulated predicts peak and 6-month event-free survival in patients with advanced chronic heart failure. In this population, however, peak appears to be superior to the 6'WT in predicting longer-term survival. Given its safety, ease of administration, and low cost, the 6'WT may play an important role in the serial assessment of functional capacity in patients with advanced heart failure. The role of the 6'WT in determining the appropriateness and
Peak =Distance
Peak max=0.03×distance (m)+3.98
r=0.64; rM.42; p<0.0001; SEE=3.32
Peak =Distance+Age+Weight+Height+RPP
Peak =0.02×distance (m)-0.191×age (yr)-0.07×weight (kg)+ 0.09×height (cm)+0.26×RPP (×10–3)+2.45
r=0.81; rM.65; p<0.0001; SEE=2.68
Peak =Distanee+Age+Weight+Height+RPP+FEV1+FVC
Peak =0.02×distance (m)-0.14×age (yr)-0.07×weight (kg)+ 0.03×height (cm)+0.23×RPP (×10–3)+0.10×FEV1 (L)-1.19×FVC (L)+7.77
r=0.83; r2=o.69; p<0.0001; SEE=2.59
Peak =Distance+Age+Weight+Height+RPP+LVEF + PAP+CI
Peak =0.02×distance (m)-0.15×age (yr)-0.05×weight (kg)+
0. 04×height (cm)+0.17×RPP (×10–3)+0.03×EF (%)-0.04×PAP
Peak =Distance
Peak
r-0.57; r2=0.33; p<0.0001; SEE=10.27
Peak =Distance+Age+Weight+Height+RPP
Peak =0.05×distance (m)-0.22×age (yr)+0.27×weight (kg)+ 0.14×height (cm)+0.78×RPP (×10–3)+26.16
r=0.71; r2=0.51; p<0.0001; SEE=9.20
Peak =Distance+Age+Weight+Height+RPP+FEV1+FVC
Peak =0.05×distance (m)-0.10×age (yr)+0.27×weight (kg)+ 0.31×height (cm)+0.69×RPP (×10–3)-1.54×FEV1 (L)-4.64×FVC (L)+40.64
r=0.74; r2=0.54; p<0.0001; SEE=9.10
Peak =Distance+Age+Weight+Height+RPP+LVEF + PAP+CI
Peak =0.04×distance (m)-0.19×age (yr)+0.35×weight (kg)+ 0.35×height (cm)+0.30×RPP (×10–3)+0.27×EF
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