PMID- 37245248
OWN - NLM
STAT- MEDLINE
DCOM- 20230619
LR  - 20231117
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 199
DP  - 2023 Jul 15
TI  - Prognostic Value of 6-Minute Walk Test in Advanced Heart Failure With Reduced 
      Ejection Fraction.
PG  - 37-43
LID - S0002-9149(23)00270-9 [pii]
LID - 10.1016/j.amjcard.2023.04.041 [doi]
AB  - There is limited evidence regarding the prognostic value of the 6-minute walk 
      test for patients with advanced heart failure (HF). Accordingly, we studied 260 
      patients presenting to inpatient cardiac rehabilitation (CR) with advanced HF. 
      The primary outcome was 3-year all-cause mortality after discharge from CR. The 
      association between 6-minute walk distance (6MWD) and the primary outcome was 
      determined using the multivariable Cox regression analysis. To avoid 
      collinearity, 6MWD at admission (6MWD(adm)) to CR and 6MWD at discharge 
      (6MWD(disch)) from CR were analyzed separately. At multivariable analysis, 4 
      baseline characteristics (age, ejection fraction, systolic blood pressure, and 
      blood urea nitrogen) were identified as prognostic of the primary outcome 
      (baseline risk model). After adjusting for the baseline risk model, the hazard 
      ratios of 6MWD(adm) and 6MWD(disch) modeled as per 50-m 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 adjusting for the 
      Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) score, the 
      corresponding hazard ratios were 0.91 (95% CI 0.84 to 0.98, p = 0.017) and 0.93 
      (95% CI 0.88 to 0.99, p = 0.016). The addition of either 6MWD(adm) or 6MWD(disch) 
      to the baseline risk model or the MAGGIC score yielded a statistically 
      significant increase in global chi-square and in the net proportion of survivors 
      reclassified downward. In conclusion, our data suggest that the distance covered 
      during a 6-minute walk test predicts survival and provides incremental prognostic 
      information on the top of well-established prognostic factors and the MAGGIC risk 
      score in advanced HF.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Scrutinio, Domenico
AU  - Scrutinio D
AD  - Scientific Clinical Institutes Maugeri, Institutes of Care and Research, 
      Institute of Bari, Bari, Italy. Electronic address: 
      domenico.scrutinio@icsmaugeri.it.
FAU - Guida, Pietro
AU  - Guida P
AD  - Regional General Hospital "F. Miulli," Acquaviva delle Fonti, Bari, Italy.
FAU - Passantino, Andrea
AU  - Passantino A
AD  - Scientific Clinical Institutes Maugeri, Institutes of Care and Research, 
      Institute of Bari, Bari, Italy.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20230526
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
CIN - Am J Cardiol. 2023 Aug 15;201:359-361. PMID: 37438224
MH  - Humans
MH  - Prognosis
MH  - Stroke Volume/physiology
MH  - Walk Test
MH  - *Heart Failure
MH  - *Cardiac Rehabilitation
MH  - Chronic Disease
COIS- Declaration of Competing Interest The authors have no conflicts of interest to 
      declare.
EDAT- 2023/05/28 19:11
MHDA- 2023/06/19 13:09
CRDT- 2023/05/28 18:00
PHST- 2023/03/14 00:00 [received]
PHST- 2023/04/13 00:00 [revised]
PHST- 2023/04/30 00:00 [accepted]
PHST- 2023/06/19 13:09 [medline]
PHST- 2023/05/28 19:11 [pubmed]
PHST- 2023/05/28 18:00 [entrez]
AID - S0002-9149(23)00270-9 [pii]
AID - 10.1016/j.amjcard.2023.04.041 [doi]
PST - ppublish
SO  - Am J Cardiol. 2023 Jul 15;199:37-43. doi: 10.1016/j.amjcard.2023.04.041. Epub 
      2023 May 26.