Key result
A 6-minute walk test increases seated PASP by ~6 mmHg in ambulatory HF patients.
Why the study?
The relationship between resting pulmonary artery pressure and pressure responses to a 6-minute walk test in ambulatory heart failure patients with an implantable sensor was not fully understood.
Does a 6-minute walk test increase pulmonary artery pressure in ambulatory patients with heart failure using an implantable hemodynamic monitor?
Observational (n=66)
Yes
Does a 6-minute walk test increase pulmonary artery pressure in ambulatory patients with heart failure using an implantable hemodynamic monitor?
In ambulatory heart failure patients with an implantable hemodynamic monitor, pulmonary artery pressures increase significantly with mild exercise (6MWT), particularly in those with elevated baseline resting pressures.
Clinicians should standardize rest before PAP readings from monitors; leaves open the prognostic value of exertional changes in ambulatory HF.
Background In this multicenter prospective study, we explored the relationship between pulmonary artery pressure (PAP) at rest and in response to a 6-min walk test (6MWT) in ambulatory patients with heart failure (HF) with an implantable PAP sensor (CardioMEMS, Abbott). Methods Between 5/2019 and 2/2021, HF patients with a CardioMEMS sensor were recruited from seven sites. PAP was recorded in the supine and seated position at rest and in the seated position immediately post-exercise. Results In our cohort of 66 patients, mean age was 70 ± 12 years, 67% male, left ventricular ejection fraction (LVEF) < 50% in 53%, mean 6MWT distance was 277 ± 95 meters. Resting seated PAPs were 31 ± 15 mmHg (systolic), 13 ± 8 mmHg (diastolic), and 20 ± 11 mmHg (mean). The pressures were lower in the seated rather than the supine position. After 6MWT, the pressures increased to PAP systolic 37 ± 19 mmHg ( p < 0.0001), diastolic 15 ± 10 mmHg ( p = 0.006), and mean 24 ± 13 mmHg ( p < 0.0001). Patients with elevated PAP diastolic at rest (>15 mmHg) demonstrated a greater increase in post-exercise PAP. Conclusion The measurement of PAP with CardioMEMS is feasible immediately post-exercise. Despite being well-managed, patients had severely limited functional capacity. We observed a significant increase in PAP with ambulation which was greater in patients with higher baseline pressures.
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Khedraki et al. (2023) conducted an observational in Heart failure (n=66). 6-minute walk test (6MWT) vs. Rest (pre-exercise seated position) was evaluated on Seated systolic pulmonary artery pressure (PASP) in mmHg (p=<0.0001). A 6-minute walk test significantly increased seated systolic pulmonary artery pressure from 31 mmHg at rest to 37 mmHg immediately post-exercise in ambulatory patients with heart failure.
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