The following is a summary of “Prognostic Value of 6-Minute Walk Test in Advanced Heart Failure With Reduced Ejection Fraction,” published in the July 2023 issue of the Cardiovascular Disease by Scrutinio et al.
There is limited evidence regarding the prognostic value of the 6-minute walk test for patients with advanced heart failure (HF). However, it is essential to note that further research is needed to understand its potential prognostic significance in this patient population fully. Accordingly, a study was conducted on 260 patients who presented to inpatient cardiac rehabilitation (CR) with advanced heart failure (HF). The primary outcome measure was the mortality rate due to any cause within 3 years following discharge from cardiac rehabilitation. The correlation between the 6-minute walk distance (6MWD) and the primary outcome was assessed using multivariable Cox regression analysis.
To prevent collinearity, the investigation was conducted separately for the 6-minute walk distance at admission to cardiac rehabilitation (6MWDadm) and the 6-minute walk distance at discharge from cardiac rehabilitation (6MWDdisch). During the multivariable analysis, four baseline characteristics, namely age, ejection fraction, systolic blood pressure, and blood urea nitrogen, were determined to be prognostic indicators of the primary outcome according to the baseline risk model. After accounting for the baseline risk model, the hazard ratios of 6-minute walk distance upon admission and 6-minute walk distance upon discharge, modeled as a 50-meter increase, for the primary outcome were 0.92 (95% confidence interval [CI] 0.85 to 0.99, P = 0.035) and 0.93 (95% CI 0.88 to 0.99, P −017), respectively. After accounting for the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) score, the hazard ratios were found to be 0.91 (95% CI 0.84 to 0.98, P= 0.017) and 0.93 (95% confidence interval 0.88 to 0.99, P = 0.016).
The inclusion of either 6-minute walk distance at admission (6MWDadm) or 6-minute walk distance at discharge (6MWDdisch) to the baseline risk model or the MAGGIC score resulted in a statistically significant increase in the overall chi-square value and in the proportion of survivors who were reclassified to a lower risk category. In summary, the researcher’s findings indicate that the distance traversed during a 6-minute ambulation assessment indicates survival rates and offers additional predictive insights alongside established prognostic factors and the MAGGIC risk score in cases of advanced heart failure.
Source: sciencedirect.com/science/article/abs/pii/S0002914923002709
