Patients in the lowest and middle baseline 6-minute walk test tertiles had a worse prognosis compared to those in the highest tertile (> 360 m) (adjusted HR 1.73; 95% CI 1.38-2.18).
Cohort
Yes
Does baseline and changing 6-minute walk test distance predict prognosis in patients with heart failure?
Baseline 6MWT distance and its decline are associated with worse prognosis in heart failure patients but do not improve existing prognostic models or reflect treatment up-titration benefits.
Effect estimate: adjusted HR 1.73 (95% CI 1.38-2.18)
BACKGROUND: The 6-minute walk test (6MWT) is a simple and inexpensive way of measuring exercise capacity in patients with heart failure (HF) that predicts morbidity and mortality. However, there are few reports from large multicentre cohorts assessing the predictive value of baseline and changing walk distance. METHODS AND RESULTS: ) of the 6MWT distance at baseline was 300 m (200-388 m). Independent predictors of a shorter 6MWT distance included older age, female sex, higher heart rate, New York Heart Association class III/IV, orthopnoea, ischaemic heart disease, a previous stroke, current malignancy, and higher N-terminal pro-B-type natriuretic peptide (all P 360 m), those in the lowest and middle tertiles had a worse prognosis adjusted hazard ratio (HR) 1.73, 95% confidence interval (CI) 1.38-2.18. Patients with a decrease in the distance walked had a worse prognosis (adjusted HR for each 50 m decrease 1.09, 95% CI 1.06-1.12). 6MWT distance was not modified by treatment up-titration nor the 6MWT improved the BIOSTAT-CHF prognostic models. CONCLUSIONS: The 6-minute walk test distance at baseline and a decline in walking distance were both associated with worse prognosis but did not improve the prognostic models. 6MWT distance was not modified by treatment up-titration and its use for assessing the benefits of pharmacologic treatment up-titration may be limited.
Ferreira et al. (Tue,) conducted a cohort in Heart failure. Lowest and middle baseline 6MWT tertiles (≤ 360 m) vs. Highest baseline 6MWT tertile (> 360 m) was evaluated on Prognosis (adjusted HR 1.73, 95% CI 1.38-2.18). Patients in the lowest and middle baseline 6-minute walk test tertiles had a worse prognosis compared to those in the highest tertile (> 360 m) (adjusted HR 1.73; 95% CI 1.38-2.18).