Oxygen desaturation on the six-minute walk test and mortality in untreated primary pulmonary hypertension

Paciocco, Giuseppe; Martínez, Fernando J.; Bossone, Eduardo; Pielsticker, Elizabeth; Gillespie, Brenda W.; Rubenfire, Melvyn

doi:10.1183/09031936.01.17406470

Cited by 236 publications

(150 citation statements)

References 21 publications

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“…In particular, in the short-distance group the survival rate at 20 months was 20%, compared with the long-distance group in which there was a 90% survival rate [197]. Exercise-induced hypoxaemia as measured by pulse oximetry during the 6-MWT was observed to be significantly predictive of mortality in patients with PPH [198].…”

Section: -Mwd and Arterial Desaturationmentioning

confidence: 91%

Recommendations on the use of exercise testing in clinical practice

Palange¹,

Ward²,

Carlsen³

et al. 2006

European Respiratory Journal

549

390

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Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest.For symptom-limited incremental exercise, CPET indices, such as peak O 2 uptake (V9O 2 ), V9O 2 at lactate threshold, the slope of the ventilation-CO 2 output relationship and the presence of arterial O 2 desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable.In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) ''When should an evaluation of exercise intolerance be sought?''; 2) ''Which particular form of test should be asked for?''; and 3) ''What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?''

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Section: -Mwd and Arterial Desaturationmentioning

confidence: 91%

Recommendations on the use of exercise testing in clinical practice

Palange¹,

Ward²,

Carlsen³

et al. 2006

European Respiratory Journal

549

390

View full text Add to dashboard Cite

show abstract

“…Myiamoto et al 13 showed that the distance walked decreases in proportion to the increase in functional class and those who walked fewer than 332 meters had a higher mortality rate when compared to individuals who walked more than that distance 13,34 . These authors also showed that, for each 50-meter increase in the 6MWT, there was an 18% decrease in the risk of death.…”

Section: Discussionmentioning

confidence: 99%

Perfil hemodinâmico de gravidade ao teste de vasorreatividade pulmonar em esquistossomóticos

Japyassú¹,

Mendes²,

Bandeira³

et al. 2012

Arq. Bras. Cardiol.

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“…5 The 6MWT is a significant predictor of survival in patients with IPAH. [7][8][9][10][11] It is still used in clinical trials for IPAH medication use. 12 Although performing a simpler submaximal test, like the 6MWT, with children with IPAH may predict peak V o 2 , it would not give health care professionals the necessary information to evaluate functional capacity.…”

Section: Discussionmentioning

confidence: 99%

“…2 In addition, the 6MWT is a significant predictor of survival in patients with pulmonary hypertension [7][8][9][10][11] and is used in clinical trials for IPAH medications. 12 In addition to other health limiting and debilitating conditions, patients with lung or heart disease may show a reduced 6-minute walk distance (6MWD).…”

Section: Doi: 101097/hcr0000000000000174mentioning

confidence: 99%

Predicting Peak Oxygen Uptake From the 6-Minute Walk Test in Patients With Pulmonary Hypertension

Zapico

Fuentes

Rojo-Tirado

et al. 2016

Journal of Cardiopulmonary Rehabilitation and Prevention

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exercise testing oxygen uptake pulmonary hypertension ■ PURPOSE: To determine whether the 6-minute walk test (6MWT) is a predictor of peak oxygen uptake (Vo 2 ) in patients with idiopathic pulmonary arterial hypertension (IPAH).■ METHODS: A total of 157 patients treated for IPAH completed a 6MWT in accordance with American Thoracic Society standards. Heart rate, pulse oximetry, and Borg rating of perceived exertion were determined at baseline and posttest. A cardiopulmonary exercise test (CPET) was performed on a cycle ergometer using a ramp protocol. Participants were stratified post hoc by age into 3 groups: children (n = 26), adolescents (n = 49), and adults (n = 82). Multiple linear regression analysis was performed to predict peak Vo 2 from the 6MWT.■ RESULTS: The regression equation generated for the children was the only model to strongly predict peak Vo 2 (r = 0.87; P < .001). Similar models for adolescent (r = 0.59; P < .001) and adult groups (r = 0.68; P < .001) did not achieve the same level of correlation.■ CONCLUSION: Six-Minute Walk Test was able to accurately predict peak Vo 2 in children (6-12 years) with IPAH; however, the model was weaker for predicting peak Vo 2 in older populations. These findings suggest that 6MWT may be as valid a test for predicting peak Vo 2 in children with IPAH as CPET measured peak Vo 2 . In older IPAH populations, CPET is the only reliable method for the evaluation of peak Vo 2 . The cardiopulmonary response to exercise is an important clinical assessment tool, as it provides an integrated assessment of the respiratory, cardiac, and metabolic systems. The current gold standard method for assessing aerobic exercise response in humans is the maximum incremental cardiopulmonary exercise test (CPET). Peak V o 2 , measured by a CPET, has been widely used to assess functional capacity and predict survival in patients with advanced symptomatic heart failure and respiratory dysfunction. 1,2 However, CPET requires the use of expensive equipment and trained medical team supervision to conduct and evaluate each test. Submaximal tests, like the 6-minute walk test (6MWT), provide useful information on daily physical performance that are safe, simple, standardized, and inexpensive. The 6MWT offers a better estimation of daily living activities than other walk tests 3 and the American Thoracic Society has endorsed and published guidelines for performing the 6MWT in clinical settings. 4

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Oxygen desaturation on the six-minute walk test and mortality in untreated primary pulmonary hypertension

Cited by 236 publications

References 21 publications

Recommendations on the use of exercise testing in clinical practice

Recommendations on the use of exercise testing in clinical practice

Perfil hemodinâmico de gravidade ao teste de vasorreatividade pulmonar em esquistossomóticos

Predicting Peak Oxygen Uptake From the 6-Minute Walk Test in Patients With Pulmonary Hypertension

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