Key result
High pre-discharge heart rate walking speed index linked to ~13-fold greater MACE risk in AHF.
Why the study?
The study aimed to determine and compare the role of pre-discharge 6MWD, RPP changes, and HRWSI from a 6MWT in predicting post-discharge outcomes in patients with acute heart failure.
Do 6MWT pre-discharge parameters (6MWD, RPP changes, HRWSI) predict MACE within 90 days in patients with acute heart failure?
Cohort (n=70)
No
Do 6MWT pre-discharge parameters (6MWD, RPP changes, HRWSI) predict MACE within 90 days in patients with acute heart failure?
Hazard Ratio: 13.549 (95% CI 3.611–50.839)
p-value: p=<0.001
Pre-discharge 6MWT parameters, specifically HRWSI and RPP changes, show potential as noninvasive predictors of 90-day MACE in acute heart failure patients.
HRWSI and RPP changes may aid pre-discharge MACE prediction in acute HF; hypothesis-generating and requires prospective validation.
Background: Heart failure (HF) is a significant cause of morbidity and mortality worldwide in middle-aged and older adults. A simple 6MWT assay can provide useful information noninvasively for risk stratification and patient prognosis. A potential parameter is incorporating pulse and blood pressure values into RPP and pulse rate with WS into HRWSI. It is easy to assess the risk of rehospitalization and mortality in HF patients and can be compared with conventional predictors and predictors with expensive biomarker examinations. Aims: To determine the role and comparison of 6MWD, RPP changes and HRWSI in patients with acute heart failure outcomes. Methods: This study was conducted with a prospective observational cohort design. This study is a collaborative study to determine whether 6MWD, changes in RPP and HRWSI at 6MWT pre-discharge can predict MACE events within 90 days after hospital discharge in patients with AHF. Result: The AUC value of 6WMD was 0.338, with a cut-off of 251.0 meters. The sensitivity and specificity of 6MWD were 72% and 63.5%. The AUC value of RPP changes was 0.692 with a cut point 3139.5. The sensitivity and specificity of RPP changes for MACE prediction were 90.0% and 48.0%. HRWSI AUC value was 0.721, with a cut-off of 22.66. The sensitivity and specificity of HRWSI was 80.0% and 64.0%. Low 6MWD had a survival of 54.6%, while patients with GJA who had high 6MWD had an 84.6% survival. Low RPP changes had a survival of 92.3%, and patients with high RPP changes had a survival of 58.8%. Low HRWSI had 88.9% survival, and patients with high RPP changes had 52.5% survival. Conclusion: 6MWD, changes in RPP and HRWSI of 6MWT are potential predictors for MACE within 90 days post hospital discharge in patients with acute heart failure.
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Yudistira et al. (2023) conducted a cohort in Acute Heart Failure (n=70). Heart rate walking speed index (HRWSI) during pre-discharge 6-minute walk test vs. HRWSI ≤ 22.66 was evaluated on Major Adverse Cardiac Event (MACE) within 90 days (HR 13.549, 95% CI 3.611-50.839, p=<0.001). A pre-discharge heart rate walking speed index greater than 22.66 was a strong independent predictor of major adverse cardiac events within 90 days in patients with acute heart failure (HR 13.55).
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