Prognostic value of 6‐minute walk corridor test in patients with mild to moderate heart failure: comparison with other methods of functional evaluation

Abstract

Aim: The study was designed to evaluate the prognostic value of the 6-min walk test (6MWT) in patients with mild to moderate congestive heart failure (CHF). Methods and results: Two hundred and fourteen patients (119 men and 95 women, mean age 64 years) were followed for a mean period of 34 months to assess event-free survival (death, heart transplantation). Sixty-six patients (34%) died (63 cardiovascular causes, 2 cancer and 1 stroke) and five patients underwent heart transplantation. For patients who walked -300 m during the 6MWT, survival was 62% compared with 82% in patients who walked 300-450 m or)450 m. With univariate analysis, NYHA class was the strongest predictor of death. LVEF (P-0.0001), aetiology of heart failure (P-0.001), LV filling pattern (Ps0.002) and 6MWT distance (P-0.01) were all significantly related to survival. No significant relationship was found between survival, peak oxygen consumption or anaerobic threshold. Multivariate analysis using the Cox-stepwise regression model showed that LV fractional shortening (P-0.009) and 6MWT distance (P-0.0005) were the strongest prognostic markers. Conclusion: A 6MWT distance of -300 m is a simple and useful prognostic marker of subsequent cardiac death in unselected patients with mild to moderate CHF.

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

“…There is also sufficient evidence that patients with poor physical conditions and low anaerobic threshold have greater post‐operative morbidity and mortality 12. In patients with cardiopulmonary disease, a 6‐min walking distance (6MWD) < 350 m predicts mortality 13. Similarly, in colorectal surgery patients, the 6MWD (which has a weak inverse correlation with sarcopenia) was found to correlate well with peak oxygen consumption in predicting post‐operative cardiopulmonary complications 14…”

Análise comparativa do teste de caminhada de seis minutos em crianças e adolescentes saudáveis

“…The performance of two tests in each of the corridors aimed to exclude a possible learning effect because, to attain reproducibility, the walked distance during the second test could not be greater than 10% compared to the first test. If this happened, it would be necessary to carry out a third test in the respective corridor 9 .…”

“…The walked distance is considered a criterion for prognosis of the functional capacity and can be influenced by the length of the corridor 2,8,9 .…”

“…Several studies have investigated the applicability and efficiency of the 6MWT in different populations, testing its validity, reliability and interpretability, thus establishing reference values and equations to interpret the test results [8][9][10][11][12][13][14] . Some of these studies demonstrated the validity and applicability of the 6MWT in heart and respiratory diseases [15][16][17][18] and others in children and adolescents, but the reproducibility criteria were based on the adult population 8,[11][12][13][14]19 .…”

“…Despite the ATS standardization for the length of the corridor during the test for adults (30.5 meters), some studies have used different lengths in order to make test performance viable [7][8][9] . Li et al 19 conducted a large study on children and adolescents with the aim of establishing reference values for the 6MWT in this population, however the length of the corridor followed the ATS criteria.…”