PMID- 28532772
OWN - NLM
STAT- MEDLINE
DCOM- 20170810
LR  - 20170810
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 120
IP  - 2
DP  - 2017 Jul 15
TI  - Echocardiographic Predictors for Worsening of Six-Minute Walk Distances in 
      Patients With Systemic Sclerosis (Scleroderma).
PG  - 315-321
LID - S0002-9149(17)30712-9 [pii]
LID - 10.1016/j.amjcard.2017.04.024 [doi]
AB  - Change in 6-minute walk distance (6MWD) has been used as a clinical marker in 
      pulmonary hypertension. Determinants and worsening of 6MWD remain a matter of 
      debate because nonpulmonary factors have an impact on the 6MWD. We hypothesized 
      that future reduction of 6MWD in patients with systemic sclerosis (SSc) was more 
      closely associated with cardiac dysfunction. We prospectively performed standard 
      clinical and echocardiographic evaluations in SSc patients with the 6-minute walk 
      test at enrollment. Features associated with the 6MWD were sought in a multiple 
      linear regression analysis and compared using standardized beta. Worsening of the 
      6MWD was defined as a 15% reduction and served as the primary outcome. Eighty-one 
      patients were included. In the multivariate analysis, baseline 6MWD was related 
      to SSc severity score (beta = -0.250, p = 0.024), left atrial volume index 
      (beta = -0.222, p = 0.046), right ventricular fractional area change (beta = 0.252, p = 
      0.025), and the ratio of mean pulmonary artery pressure and cardiac output 
      (beta = -0.31, p = 0.002). During follow-up, 20 patients reached the primary 
      outcome. In sequential Cox models, a model based on right ventricular fractional 
      area change at baseline (chi-square 4.8) was improved by left atrial volume index 
      (chi-square 10.3, p = 0.007). In conclusion, determinants and worsening of 6MWD 
      are explained by cardiac factors. When using the 6MWD as a clinical marker in 
      pulmonary hypertension patients, their left ventricular diastolic function and 
      right ventricular systolic function should be taken into consideration.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Kusunose, Kenya
AU  - Kusunose K
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
FAU - Yamada, Hirotsugu
AU  - Yamada H
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan. Electronic address: yamadah@tokushima-u.ac.jp.
FAU - Nishio, Susumu
AU  - Nishio S
AD  - Department of Ultrasound Examination Center, Tokushima University Hospital, 
      Tokushima, Japan.
FAU - Hirata, Yukina
AU  - Hirata Y
AD  - Department of Ultrasound Examination Center, Tokushima University Hospital, 
      Tokushima, Japan.
FAU - Seno, Hiromitsu
AU  - Seno H
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
FAU - Saijo, Yoshihito
AU  - Saijo Y
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
FAU - Ise, Takayuki
AU  - Ise T
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
FAU - Tobiume, Takeshi
AU  - Tobiume T
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
FAU - Yamaguchi, Koji
AU  - Yamaguchi K
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
FAU - Yagi, Shusuke
AU  - Yagi S
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
FAU - Soeki, Takeshi
AU  - Soeki T
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
FAU - Wakatsuki, Tetsuzo
AU  - Wakatsuki T
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
FAU - Sata, Masataka
AU  - Sata M
AD  - Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, 
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20170426
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Diastole
MH  - Disease Progression
MH  - Echocardiography, Doppler/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension, Pulmonary/*diagnosis/etiology/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Scleroderma, Systemic/complications/*diagnosis/physiopathology
MH  - Stroke Volume/*physiology
MH  - Systole
MH  - Time Factors
MH  - Ventricular Function, Left/*physiology
MH  - Ventricular Function, Right/*physiology
MH  - Walking/*physiology
EDAT- 2017/05/24 06:00
MHDA- 2017/08/11 06:00
CRDT- 2017/05/24 06:00
PHST- 2017/01/30 00:00 [received]
PHST- 2017/04/12 00:00 [revised]
PHST- 2017/04/12 00:00 [accepted]
PHST- 2017/05/24 06:00 [pubmed]
PHST- 2017/08/11 06:00 [medline]
PHST- 2017/05/24 06:00 [entrez]
AID - S0002-9149(17)30712-9 [pii]
AID - 10.1016/j.amjcard.2017.04.024 [doi]
PST - ppublish
SO  - Am J Cardiol. 2017 Jul 15;120(2):315-321. doi: 10.1016/j.amjcard.2017.04.024. 
      Epub 2017 Apr 26.