Key result
Repeat walking distance tests in HFrEF yield a clinically insignificant ~11 m increase over initial testing.
Why the study?
Two baseline 6MWTs have been recommended to mitigate a potential learning effect, but the magnitude of any learning effect in HFrEF is uncertain.
Does a repeat 6-minute walk test provide clinically meaningful information compared to a single test in patients with symptomatic HFrEF and pulmonary hypertension?
Observational (n=69)
Does a repeat 6-minute walk test provide clinically meaningful information compared to a single test in patients with symptomatic HFrEF and pulmonary hypertension?
In symptomatic HFrEF with pulmonary hypertension, a single baseline 6-minute walk test is sufficient to assess functional capacity, as the learning effect from a repeat test is small and not clinically meaningful.
Answers are grounded in this paper and cite their sources.
Single 6MWT may suffice for HFrEF exercise assessment; leaves open whether two tests add value in other phenotypes or endpoints.
Background Two baseline 6-minute walk tests (6MWTs) have been recommended to mitigate a potential learning effect when assessing exercise performance, but the magnitude of any learning effect in heart failure with reduced ejection fraction (HFrEF) is uncertain. Using the Sildenafil in Heart Failure (SilHF) trial, in which two baseline 6MWTs were performed (screening and inclusion), we assessed a potential learning effect in this population. We also assessed whether choice of baseline test affected associations with longitudinal patient-reported outcomes and compared our findings to reports in the current literature. Methods and results In SilHF, 69 patients with HFrEF and evidence of pulmonary hypertension performed 6MWTs at screening and again at study inclusion. Tests were performed no more than two weeks apart on unchanged optimal medical therapy. Only the inclusion 6MWT was used for efficacy evaluation of sildenafil. Screening and inclusion distances were compared using a paired t-test. Additionally, we assessed whether each baseline 6MWT (screening and inclusion) correlated with longitudinal patient-reported outcome measures. Outcomes included the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQoL-5D visual analogue scale (EQ-5D VAS), assessed at 24 weeks. Although the inclusion 6MWT distance was statistically significantly higher than the screening test (+11.3 m, 95% CI 2.6 to 20.1, p = 0.012), the two baseline tests demonstrated very similar correlation coefficients with longitudinal patient-reported outcomes. Conclusion We observed a small increase in 6MWD between repeat baseline tests, consistent with a modest learning effect that is unlikely to be clinically meaningful. Both initial 6MWTs showed similar significant correlations with other longitudinal patient-reported outcome measures. In symptomatic HFrEF with pulmonary hypertension, a single baseline 6MWT may be sufficient to assess functional capacity.
No takes yet. Share an insight, caveat, or question.
Cooper et al. (2026) conducted an observational in Heart failure with reduced ejection fraction (HFrEF) and pulmonary hypertension (n=69). Repeat 6-minute walk test (inclusion) vs. Initial 6-minute walk test (screening) was evaluated on Difference in 6-minute walk test distance between inclusion and screening (MD 11.3 m, 95% CI 2.6 to 20.1, p=0.012). A repeat baseline walking distance test in HFrEF patients yielded a small, clinically insignificant increase in distance compared to the initial test.
Synapse has enriched 10 related papers. Consider them for comparative context: