PMID- 25312386
OWN - NLM
STAT- MEDLINE
DCOM- 20151215
LR  - 20150327
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 34
IP  - 3
DP  - 2015 Mar
TI  - Predicting outcomes in pulmonary arterial hypertension based on the 6-minute walk 
      distance.
PG  - 362-8
LID - S1053-2498(14)01296-0 [pii]
LID - 10.1016/j.healun.2014.08.020 [doi]
AB  - BACKGROUND: Clinical studies of pulmonary arterial hypertension have used the 
      change in the 6-minute walk distance (6MWD) as a clinical end point; however, its 
      association with survival outcomes has not been well established. In this 
      analysis, we examined the prognostic value of the baseline 6MWD, absolute 
      thresholds of the 6MWD, and change in the 6MWD. METHODS: Patients in the Registry 
      to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease 
      Management (REVEAL) with 6MWD at enrollment, with or without a follow-up 
      assessment within the first year of observation, were included. Kaplan-Meier 
      survival estimates were computed for sub-sets with baseline 6MWD results that 
      were above or below all possible thresholds and for sub-sets with a change in the 
      6MWD that was 10 percentage points above or below all possible thresholds, 
      including improvement thresholds and worsening thresholds. Multivariable Cox 
      regression models assessed the effect of improvement and worsening in the 6MWD on 
      1-year survival, adjusted for baseline factors. RESULTS: One-year survival 
      estimates were higher for patients with a baseline 6MWD above vs below a 
      threshold, although no specific threshold was more prognostic than another. In a 
      model adjusted for the baseline 6MWD and risk score, worsening of the 6MWD over 
      time significantly predicted decreased survival, but improvement in the 6MWD did 
      not affect survival. CONCLUSIONS: No 6MWD improvement threshold carries 
      particular prognostic value. Improvement in the 6MWD was not associated with 
      survival, but worsening of the 6MWD was strongly and significantly associated 
      with poor prognosis.
CI  - Copyright (c) 2015 International Society for Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Farber, Harrison W
AU  - Farber HW
AD  - Division of Pulmonary, Critical Care, Sleep Medicine and Allergy, The Pulmonary 
      Center, Boston University School of Medicine, Boston, Massachusetts. Electronic 
      address: hfarber@bu.edu.
FAU - Miller, Dave P
AU  - Miller DP
AD  - ICON Clinical Research, San Francisco, California.
FAU - McGoon, Michael D
AU  - McGoon MD
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; Division 
      of Cardiovascular Diseases, Allegheny General Hospital, Pittsburgh, Pennsylvania.
FAU - Frost, Adaani E
AU  - Frost AE
AD  - Division of Pulmonary and Critical Care, Baylor College of Medicine, Houston, 
      Texas.
FAU - Benton, Wade W
AU  - Benton WW
AD  - Actelion Pharmaceuticals US Inc, South San Francisco, California.
FAU - Benza, Raymond L
AU  - Benza RL
AD  - Division of Cardiovascular Diseases, Allegheny General Hospital, Pittsburgh, 
      Pennsylvania.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20140828
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Disease Progression
MH  - Exercise Test/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension, Pulmonary/diagnosis/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - *Registries
MH  - Time Factors
MH  - United States/epidemiology
MH  - Walking/*physiology
OTO - NOTNLM
OT  - 6-minute walk distance
OT  - prognostic value
OT  - pulmonary arterial hypertension
OT  - surrogate end points
OT  - survival outcomes
EDAT- 2014/10/15 06:00
MHDA- 2015/12/17 06:00
CRDT- 2014/10/15 06:00
PHST- 2014/05/14 00:00 [received]
PHST- 2014/07/29 00:00 [revised]
PHST- 2014/08/27 00:00 [accepted]
PHST- 2014/10/15 06:00 [entrez]
PHST- 2014/10/15 06:00 [pubmed]
PHST- 2015/12/17 06:00 [medline]
AID - S1053-2498(14)01296-0 [pii]
AID - 10.1016/j.healun.2014.08.020 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2015 Mar;34(3):362-8. doi: 10.1016/j.healun.2014.08.020. 
      Epub 2014 Aug 28.