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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.

Authors

Ron Butterly

Rod F. King

Carlton B. Cooke

John G.J.F. Cleland

Andrew L. Clark



Abstract

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.

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. https://doi.org/10.1093/eurheartj/ehl527

Journal Article Type Article
Acceptance Date Jan 17, 2007
Online Publication Date Feb 21, 2007
Publication Date 2007-03
Deposit Date May 7, 2019
Journal European Heart Journal
Print ISSN 0195-668X
Electronic ISSN 1522-9645
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 28
Issue 5
Pages 560-568
DOI https://doi.org/10.1093/eurheartj/ehl527
Keywords Chronic heart failure; Exercise; Prognosis; Survival
Public URL https://hull-repository.worktribe.com/output/527356
Publisher URL https://academic.oup.com/eurheartj/article/28/5/560/2887708