Comparison Between 6 Minutes Walking Distance (6MWD), Changes in Rate Pressure Product (RPP) and Heart Rate Walking Speed Index (HRWSI) of 6 Minutes Walk Test (6MWT) Pre-Discharge as a Predictor Major Adverse Cardiac Event (MACE) in Patients with Acute Heart Failure

Abstract

Background: Heart failure (HF) is a significant cause of morbidity and mortality worldwide in middle-aged and older adults. A simple 6MWT assay can provide useful information noninvasively for risk stratification and patient prognosis. A potential parameter is incorporating pulse and blood pressure values ​​into RPP and pulse rate with WS into HRWSI. It is easy to assess the risk of rehospitalization and mortality in HF patients and can be compared with conventional predictors and predictors with expensive biomarker examinations. Aims: To determine the role and comparison of 6MWD, RPP changes and HRWSI in patients with acute heart failure outcomes. Methods: This study was conducted with a prospective observational cohort design. This study is a collaborative study to determine whether 6MWD, changes in RPP and HRWSI at 6MWT pre-discharge can predict MACE events within 90 days after hospital discharge in patients with AHF. Result: The AUC value of 6WMD was 0.338, with a cut-off of 251.0 meters. The sensitivity and specificity of 6MWD were 72% and 63.5%. The AUC value of RPP changes was 0.692 with a cut point 3139.5. The sensitivity and specificity of RPP changes for MACE prediction were 90.0% and 48.0%. HRWSI AUC value was 0.721, with a cut-off of 22.66. The sensitivity and specificity of HRWSI was 80.0% and 64.0%. Low 6MWD had a survival of 54.6%, while patients with GJA who had high 6MWD had an 84.6% survival. Low RPP changes had a survival of 92.3%, and patients with high RPP changes had a survival of 58.8%. Low HRWSI had 88.9% survival, and patients with high RPP changes had 52.5% survival. Conclusion: 6MWD, changes in RPP and HRWSI of 6MWT are potential predictors for MACE within 90 days post hospital discharge in patients with acute heart failure.