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Prognostic value of the 6 min walk test and self-perceived symptom severity in older patients with chronic heart failure

Ingle, Lee; Rigby, Alan S.; Carroll, Sean; Butterly, Ron; King, Rod F.; Cooke, Carlton B.; Cleland, John G.J.F.; Clark, Andrew L.


Alan S. Rigby

Ron Butterly

Rod F. King

Carlton B. Cooke

John G.J.F. Cleland

Andrew L. Clark


Background: The 6 min walk test (6-MWT) is a simple and popular test for evaluating functional status in patients with chronic heart failure (CHF). However, the prognostic value of the 6-MWT in a large, representative sample of CHF patients, and in patients with different degrees of left ventricular systolic dysfunction (LVSD) remains unclear. Methods and results: Of an initial population of 1592 patients, 212 died representing a crude death rate of 13.3%. In surviving patients, the median time to follow-up period was 36.6 months [inter-quartile range (IQR) 28-45 months]. Five variables remained independent predictors of all-cause mortality; decreasing 6-MWT distance, self-perceived signs of breathlessness at night (SOBAN), beta-blocker usage, elevated log NT-proBNP, and reduced haemoglobin concentration. We also dichotomized our analysis by LVSD status (≤mild LVSD or > mild LVSD). For patients with > mild LVSD, 6-MWT remained an important prognostic indicator but not in patients with ≤mild LVSD. Conclusion: The 6-MWT is an important independent predictor of mortality in CHF patients, and this was especially evident in patients with > mild LVSD. The 6-MWT provides little prognostic utility in patients with ≤mild LVSD. While log NT-proBNP was the most potent independent predictor, an additive prognostic effect was evident with the additional selection of 6-MWT. Patients' self-perceived symptoms, especially SOBAN was an independent predictor of mortality in our patients. © The European Society of Cardiology 2007. All rights reserved.

Journal Article Type Article
Publication Date 2007-03
Journal European Heart Journal
Print ISSN 0195-668X
Electronic ISSN 1522-9645
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 28
Issue 5
Pages 560-568
APA6 Citation Ingle, L., Rigby, A. S., Carroll, S., Butterly, R., King, R. F., Cooke, C. B., …Clark, A. L. (2007). Prognostic value of the 6 min walk test and self-perceived symptom severity in older patients with chronic heart failure. European Heart Journal, 28(5), 560-568.
Keywords Chronic heart failure; Exercise; Prognosis; Survival
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