PMID- 19136491
OWN - NLM
STAT- MEDLINE
DCOM- 20090528
LR  - 20220316
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 11
IP  - 3
DP  - 2009 Mar
TI  - Six-minute walking test predicts long-term cardiac death in patients who received 
      cardiac resynchronization therapy.
PG  - 338-42
LID - 10.1093/europace/eun362 [doi]
AB  - AIMS: Cardiac resynchronization therapy (CRT) has been proven to be effective in 
      patients suffering from chronic heart failure (CHF) associated with electrical 
      dyssynchrony. However, long-term predictors of mortality in that subset have not 
      been extensively investigated. The aim of this study was to establish baseline 
      long-term predictors of cardiovascular mortality in CHF patients treated with 
      CRT. METHODS AND RESULTS: A total of 188 consecutive patients with moderate to 
      severe CHF who had undergone a successful CRT implant were evaluated. Baseline 
      measurements included clinical history, a 6-min walking test (6MWT), and 
      echocardiographic parameters. Patients with cardiac or non-cardiac diseases 
      limiting their ability to perform a 6MWT were excluded, with the final count 
      totalling 155 patients [82% men, mean age 69 +/- 8 years, New York Heart 
      Association (NYHA) functional class: II 22%, III 73.5%, IV 4.5%]. A total of 24 
      patients (15.5%) died of cardiovascular causes and one patient underwent heart 
      transplantation during a mean follow-up of 24.4 +/- 18.1 months. Univariate 
      analysis showed that NYHA class, distance walked in the 6MWT, left atrial 
      diameter, digoxine and left ventricle (LV) ejection fraction were all 
      significantly related to rates of mortality. Multivariate Cox regression after 
      adjustment for the presence of a defibrillator showed that the LV ejection 
      fraction [HR 0.91 (95% CI: 0.84-0.98) P = 0.008] and 6MWT distance <225 m [HR 5.6 
      (95% CI: 1.2-25.3) P = 0.026] were independent predictors of cardiovascular 
      mortality. CONCLUSION: Baseline functional capacity, measured by the 6MWT 
      distance, and LV ejection fraction are independent predictors of mortality in 
      moderate to severe CHF patients, despite CRT. A 6MWT distance walked of <225 m 
      identifies patients at high risk of cardiovascular death at mid-long term.
FAU - Castel, Maria Angeles
AU  - Castel MA
AD  - Thorax Clinic Institute, Hospital Clinic, Institut d'Investigacions Biomediques 
      August Pi i Sunyer, University of Barcelona, Villarroel 170 Barcelona 08036, 
      Catalonia, Spain.
FAU - Mendez, Francisco
AU  - Mendez F
FAU - Tamborero, David
AU  - Tamborero D
FAU - Mont, Lluis
AU  - Mont L
FAU - Magnani, Santiago
AU  - Magnani S
FAU - Tolosana, Jose Maria
AU  - Tolosana JM
FAU - Berruezo, Antonio
AU  - Berruezo A
FAU - Godoy, Miguel
AU  - Godoy M
FAU - Sitges, Marta
AU  - Sitges M
FAU - Vidal, Barbara
AU  - Vidal B
FAU - Roig, Eulalia
AU  - Roig E
FAU - Brugada, Josep
AU  - Brugada J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090109
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
CIN - Europace. 2009 Mar;11(3):280-2. PMID: 19164360
MH  - Aged
MH  - Cardiac Pacing, Artificial/*mortality
MH  - Exercise Test/*statistics & numerical data
MH  - Female
MH  - Heart Failure/*mortality/*prevention & control
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Sensitivity and Specificity
MH  - Spain/epidemiology
MH  - *Survival Analysis
MH  - Survival Rate
MH  - Walking
EDAT- 2009/01/13 09:00
MHDA- 2009/05/29 09:00
CRDT- 2009/01/13 09:00
PHST- 2009/01/13 09:00 [entrez]
PHST- 2009/01/13 09:00 [pubmed]
PHST- 2009/05/29 09:00 [medline]
AID - eun362 [pii]
AID - 10.1093/europace/eun362 [doi]
PST - ppublish
SO  - Europace. 2009 Mar;11(3):338-42. doi: 10.1093/europace/eun362. Epub 2009 Jan 9.